| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 825 NE MULTNOMAH STREET, SUITE 1500 PORTLAND, OR 97232 | PACIFICSOURCE HEALTH PLANS | $306K | $0 | $306K | 3.01% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $171K | $7K | $178K | 3.08% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 825 NE MULTNOMAH STREET, SUITE 1500 PORTLAND, OR 97232 | WILLAMETTE DENTAL INSURANCE, INC. | $39K | $0 | $39K | 5.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $35K | $8K | $42K | 18.25% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $4K | $0 | $4K | 3.39% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 825 NE MULTNOMAH STREET, SUITE 1500 PORTLAND, OR 97232 | VISION SERVICE PLAN | $22 | $0 | $22 | 0.02% |
| HEARTSEASE LLC3 Filed as: HEARTSEASE, LLC | 1521 NE 63RD AVENUE HILLSBORO, OR 97124 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $625 | $370 | $995 | 9.32% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $774 | $56 | $830 | 7.77% |
| CHRISTINE LYNN MORGESTER3 | 14913 SOUTH SUNTERRA LOOP OREGON CITY, OR 97045 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $405 | $17 | $422 | 3.95% |
| WORKSITE BENEFITS GROUP INC3 Filed as: WORKSITE BENEFITS GROUP, INC. | 112 NW 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $164 | $205 | $369 | 3.46% |
| BENEFITS BY DESIGN INC3 Filed as: BENEFITS BY DESIGN, INC., | 2101 NE 279TH STREET RIDGEFIELD, WA 98642 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $227 | $91 | $318 | 2.98% |
| SUSAN J LEACH3 Filed as: SUSAN J. LEACH AND OTHER AGENTS | 4419 NE 131ST PLACE PORTLAND, OR 97230 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $247 | $57 | $304 | 2.85% |
| KAREN CLAY KUNKLER3 | 1709 NW 45TH AVENUE CAMAS, WA 98607 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $115 | $43 | $158 | 1.48% |
| MARGARET BRYANT3 | 18014 SW BELMORE AVENUE LAKE OSWEGO, OR 97035 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $186 | $19 | $205 | 4.26% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $159 | $12 | $171 | 3.55% |
| TRICIA MILLER3 | 2101 NE 279TH STREET RIDGEFIELD, WA 98642 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $106 | $8 | $114 | 2.37% |
| HEARTSEASE LLC3 Filed as: HEARTSEASE, LLC | 1521 NE 63RD AVENUE HILLSBORO, OR 97124 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $81 | $25 | $106 | 2.20% |
| PREMIER WRKST SOLUTIONS AND AGENTS3 | 112 NW 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $61 | $22 | $83 | 1.72% |
| GORDON FREDERICK WOLLEN3 | PO BOX 846 CANNON BEACH, OR 97110 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $71 | $0 | $71 | 1.47% |
| WORKSITE BENEFITS GROUP INC3 Filed as: WORKSITE BENEFITS GROUP, INC. | 112 NW 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $32 | $23 | $55 | 1.14% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $190 | $7 | $197 | 6.83% |
| HEARTSEASE LLC3 Filed as: HEARTSEASE, LLC | 1521 NE 63RD AVENUE HILLSBORO, OR 97124 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $119 | $48 | $167 | 5.79% |
| SUSAN J LEACH3 Filed as: SUSAN J. LEACH | 4419 NE 131ST PLACE PORTLAND, OR 97230 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $79 | $2 | $81 | 2.81% |
| BENEFITS BY DESIGN INC3 Filed as: BENEFITS BY DESIGN, INC., | 2101 NE 279TH STREET RIDGEFIELD, WA 98642 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $43 | $11 | $54 | 1.87% |
| ENROLLEASE3 Filed as: DIGITAL INSURANCE, LLC AND AGENTS | 200 GALLERIA PARKWAY ATLANTA, GA 30339 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $41 | $2 | $43 | 1.49% |
| PREMIER WORKSITE SOLUTIONS INC3 Filed as: PREMIER WORKSITE SOLUTIONS, INC. | 112 NW 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $17 | $16 | $33 | 1.14% |
| WORKSITE BENEFITS GROUP INC3 Filed as: WORKSITE BENEFITS GROUP, INC. | 112 NW 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $21 | $12 | $33 | 1.14% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $87 | $0 | $87 | 4.55% |
| HEARTSEASE LLC3 Filed as: HEARTSEASE, LLC | 1521 NE 63RD AVENUE HILLSBORO, OR 97124 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $82 | $0 | $82 | 4.29% |
| BENEFITS BY DESIGN INC3 Filed as: BENEFITS BY DESIGN, INC., | 2101 NE 279TH STREET RIDGEFIELD, WA 98642 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $22 | $0 | $22 | 1.15% |
| SUSAN J LEACH3 Filed as: SUSAN J. LEACH | 4419 NE 131ST PLACE PORTLAND, OR 97230 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $17 | $0 | $17 | 0.89% |
| WORKSITE BENEFITS GROUP INC3 Filed as: WORKSITE BENEFITS GROUP, INC. | 112 NW 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $17 | $0 | $17 | 0.89% |
| PREMIER WORKSITE SOLUTIONS INC3 Filed as: PREMIER WORKSITE SOLUTIONS, INC. | 112 NW 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $8 | $0 | $8 | 0.42% |
| MARGARET BRYANT3 Filed as: MARGARET BRYANT AND OTHER AGENT | 18014 SW BELMORE AVENUE LAKE OSWEGO, OR 97035 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4 | $0 | $4 | 0.21% |
| MARGARET BRYANT3 | 18014 SW BELMORE AVENUE LAKE OSWEGO, OR 97035 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $59 | $0 | $59 | 3.86% |
| KAREN CLAY KUNKLER3 | 1709 NW 45TH AVENUE CAMAS, WA 98607 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $20 | $0 | $20 | 1.31% |
| WORKSITE BENEFITS GROUP INC3 Filed as: WORKSITE BENEFITS GROUP, INC. | 112 NW 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $9 | $0 | $9 | 0.59% |
| HEARTSEASE LLC3 Filed as: HEARTSEASE, LLC | 1521 NE 63RD AVENUE HILLSBORO, OR 97124 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5 | $0 | $5 | 0.33% |
| PREMIER WORKSITE SOLUTIONS INC3 Filed as: PREMIER WORKSITE SOLUTIONS, INC. | 112 NW 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5 | $0 | $5 | 0.33% |
| BENEFITS BY DESIGN INC3 Filed as: BENEFITS BY DESIGN, INC. AND AGENTS | 2101 NE 279TH STREET RIDGEFIELD, WA 98642 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5 | $0 | $5 | 0.33% |
| ZINA OSTER3 | 3153 FOREST DRIVE CHEYENNE, WY 82001 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3 | $0 | $3 | 0.20% |
| MARGARET BRYANT3 | 18014 SW BELMORE AVENUE LAKE OSWEGO, OR 97035 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $22 | $0 | $22 | 3.28% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $14 | $0 | $14 | 2.09% |
| KAREN CLAY KUNKLER3 | 1709 NW 45TH AVENUE CAMAS, WA 98607 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $12 | $0 | $12 | 1.79% |
| WORKSITE BENEFITS GROUP INC3 Filed as: WORKSITE BENEFITS GROUP, INC. | 112 NW 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5 | $0 | $5 | 0.75% |
| HEARTSEASE LLC3 Filed as: HEARTSEASE, LLC | 1521 NE 63RD AVENUE HILLSBORO, OR 97124 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2 | $0 | $2 | 0.30% |
| PREMIER WORKSITE SOLUTIONS INC3 Filed as: PREMIER WORKSITE SOLUTIONS, INC. | 112 NW 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2 | $0 | $2 | 0.30% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, LLC | 200 GALLERIA PARKWAY ATLANTA, GA 30339 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.15% |
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 | 1,024 | 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) | 1,024 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | PACIFICSOURCE HEALTH PLANS | 1,034 | $15.9M |
| Dental | WILLAMETTE DENTAL INSURANCE, INC. | 1,577 | $772K |
| Vision(3 contracts, 3 carriers) | PACIFICSOURCE HEALTH PLANS | 1,412 | $16.0M |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,024 | $231K |
| Prescription drug(2 contracts, 2 carriers) | PACIFICSOURCE HEALTH PLANS | 1,034 | $15.9M |
| Other(9 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,024 | $260K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,577 | — |
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."
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.