| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| J.L. JONES AND ASSOCIATES3 Filed as: J. L. JONES AND ASSOCIATES | 720 COUNTRY CLUB ROAD EUGENE, OR 97401 | LIFEMAP ASSURANCE COMPANY | $3K | — | $3K | 10.61% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF OREGON, INC. | 222 SW COLUMBIA STREET PORTLAND, OR 97201 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $928 | — | $928 | 4.59% |
| WHA INSURANCE AGENCY INC3 Filed as: WHA INS. AGENCY ANDOTHER AGENTS | 2930 CHAD DRIVE EUGENE, OR 97408 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $557 | $56 | $613 | 3.03% |
| MJ INSURANCE3 Filed as: KAREN KUNKLER | 1709 NORTHWEST 45TH AVENUE CAMAS, WA 98607 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $325 | $32 | $357 | 1.76% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE, INC. | PO BOX 29 SPRINGFIELD, OR 97477 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $312 | — | $312 | 1.54% |
| PREMIER WORKSITE SOLUTIONS INC3 Filed as: PREMIER WORKSITE SOLUTIONS, INC. | 806 NW 79TH STREET VANCOUVER, WA 98665 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $150 | $47 | $197 | 0.97% |
| BENEFITS BY DESIGN INC3 Filed as: BENEFITS BY DESIGN, INC | 2101 NORTHEAST 279TH STREET RIDGEFIELD, WA 98642 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $159 | $31 | $190 | 0.94% |
| PATRICK IAN WAGNER3 | 4580 PEBBLE BROOK LANE PLANO, TX 75093 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $140 | — | $140 | 0.69% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 142 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 146 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | LIFEMAP ASSURANCE COMPANY | 203 | $47K |
| Long-term disability | LIFEMAP ASSURANCE COMPANY | 203 | $27K |
| Other(2 contracts, 2 carriers) | LIFEMAP ASSURANCE COMPANY | 203 | $47K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 203 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.