| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF OREGON LLC | PO BOX 29018 PORTLAND, OR 97296 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $34K | $34K | 3.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF OREGON LLC | — | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13K | $2K | $15K | 11.39% |
| HEARTSEASE LLC3 | 1521 NE 63RD AVE HILLSBORO, OR 97124 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7K | $3K | $9K | 7.14% |
| WORKSITE BENEFITS GROUP INC3 Filed as: WORKSITE BENEFITS GROUP | 112 NW 114TH ST VANCOUVER, WA 98685 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $2K | $5K | 3.40% |
| BENEFITS BY DESIGN INC3 | 2101 NE 279TH ST RIDGEFIELD, WA 98642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $730 | $3K | 2.21% |
| ESSENTIAL OIL JOY3 | 2909 S HARPER VALLEY WAY RIDGEFIELD, WA 98632 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $61 | $2K | 1.86% |
| DAVID KINNEY3 | 802 NEVADA DR LONGVIEW, WA 98632 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $189 | $1K | 1.07% |
| PAMELA COPLE SMITH3 | 411 HIGHLAND DR SEATTLE, WA 98109 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $53 | $1K | 1.04% |
| MELISSA CATHLEEN HADLOCK3 | 14912 NE 249TH ST BATTLE GROUND, WA 98604 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $873 | $172 | $1K | 0.79% |
| RAQUEL LOSADA MONROY3 | 817 NE DELP RD CAMAS, WA 98607 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $708 | $103 | $811 | 0.61% |
| GABRIEL ANGEL CANALS3 | 1549 NW CIVIC DR APT 204 GRESHAM, OR 97030 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $80 | $113 | $193 | 0.15% |
| ABIGAIL TAYLOR WEILAND3 | 14511 SW CORNERSTONE LN SHERWOOD, OR 97140 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $50 | $117 | $167 | 0.13% |
| SUSAN GOLD STOKES3 | 104 MISTY HOLLOW WAY HUNTSVILLE, AL 35806 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $130 | $23 | $153 | 0.12% |
| TY ROBERT NAUGLE3 | PO BOX 80273 PORTLAND, OR 97280 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $50 | $96 | $146 | 0.11% |
| TRICIA MILLER3 | 2101 NE 279TH ST RIDGEFIELD, WA 98642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $134 | $5 | $139 | 0.10% |
| KRISTIN LEASE3 | 3890 HOWARD AVE LOS ALAMITOS, CA 90720 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | $35 | $51 | 0.04% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF OREGON LLC | PO BOX 29018 PORTLAND, OR 97296 | AMERITAS LIFE INSURANCE CORP | $3K | — | $3K | 4.97% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 3520 THOMASVILLE RD STE 500 TALLAHASSEE, FL 32309 | AMERITAS LIFE INSURANCE CORP | — | $837 | $837 | 1.53% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF OREGON LLC | — | WILLAMETTE DENTAL INSURANCE | $2K | — | $2K | 5.00% |
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 | 118 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 118 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 174 | $1.1M |
| Dental(2 contracts, 2 carriers) | AMERITAS LIFE INSURANCE CORP | 200 | $92K |
| Vision | AMERITAS LIFE INSURANCE CORP | 200 | $55K |
| Other | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 122 | $133K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 200 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.