| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COLUMBIA BENEFIT SOLUTIONS INC3 Filed as: COLUMBIA BENEFIT SOLUTIONS INC. | 16325 BOONES FERRY ROAD SUITE 204 LAKE OSWEGO, OR 97035 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $15K | — | $15K | 1.72% |
| COLUMBIA BENEFIT SOLUTIONS INC3 | 16325 BOONES FERRY ROAD SUITE 204 LAKE OSWEGO, OR 97035 | STANDARD INSURANCE COMPANY | $2K | $857 | $3K | 3.70% |
| COLUMBIA BENEFIT SOLUTIONS INC3 Filed as: COLUMBIA BENEFIT SOLUTIONS | 16325 BOONS FERRY ROAD SUITE 204 LAKE OSWEGO, OR 97035 | STANDARD INSURANCE COMPANHY | $3K | $440 | $3K | 15.41% |
| COLUMBIA BENEFIT SOLUTIONS INC3 | 16325 FERRY ROAD SUITE 204 LAKE OSWEGO, OR 97035 | STANDARE INSURANCE COMPANY | $2K | $340 | $2K | 10.81% |
| COLUMBIA BENEFIT SOLUTIONS INC3 Filed as: COLUMBIA BENEFIT SOLUTIONS | 16325 BOONES FERRY ROAD SUITE 204 LAKE OSWEGO, OR 97035 | STANDARD INSURANCE COMPANY | $1K | $249 | $2K | 11.84% |
| COLUMBIA BENEFIT SOLUTIONS INC3 | 16325 BOONES FERRY ROAD SUITE 204 LAKE OSWEGO, OR 97035 | STANDARD INSURANCE COMPANY | $57 | $47 | $104 | 4.48% |
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 | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 120 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 180 | $851K |
| Dental | STANDARD INSURANCE COMPANY | 115 | $84K |
| Vision | STANDARD INSURANCE COMPANY | 115 | $2K |
| Life insurance | STANDARE INSURANCE COMPANY | 118 | $17K |
| Short-term disability | STANDARD INSURANCE COMPANY | 118 | $13K |
| Long-term disability | STANDARD INSURANCE COMPANHY | 118 | $22K |
| Other | STANDARE INSURANCE COMPANY | 118 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 180 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.