| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN OF OR | PO BOX 743061 LOS ANGELES, CA 90074 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $25K | $2 | $25K | 2.01% |
| BROWN & BROWN INSURANCE SERVICES3 | 300 N BEACH ST DAYTONA, FL 32114 | DELTA DENTAL PLAN OF OREGON | $4K | — | $4K | 3.01% |
| BROWN & BROWN INSURANCE SERVICES3 | 601 SW 2ND AVE, STE 1200 PORTLAND, OR 97204 | STANDARD INSURANCE COMPANY | $4K | — | $4K | 7.91% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN OF NY | 595 STEWART AVE STE 700 GARDEN CITY, NY 11530 | STANDARD INSURANCE COMPANY | $1K | — | $1K | 2.29% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN OF OREGON LLC | 2701 NW VAUGHN ST # 340 PORTLAND, OR 97296 | STANDARD INSURANCE COMPANY | $409 | — | $409 | 0.76% |
| HEARTSEASE LLC3 | 1521 NE 63RD AVE HILLSBORO, OR 97124 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $622 | $3K | 8.91% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN AND BROWN OF OREGON LLC | — | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $671 | $2K | 7.96% |
| WORKSITE BENEFITS GROUP INC3 | 112 NW 114TH ST VANCOUVER, WA 98685 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $505 | $796 | $1K | 4.39% |
| BENEFITS BY DESIGN INC3 | 2101 NE 279TH ST RIDGEFIELD, WA 98642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $682 | $265 | $947 | 3.20% |
| BROWN & BROWN INSURANCE SERVICES3 | — | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $646 | $80 | $726 | 2.45% |
| MELISSA CATHLEEN HADLOCK3 | 14912 NE 249TH ST BATTLE GROUND, WA 98604 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $436 | — | $436 | 1.47% |
| GERERD PATRICK SWEENEY3 | 33753 NE HART CT SCAPPOOSE, OR 97056 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $326 | $49 | $375 | 1.27% |
| HOLLI M GUIER3 | 602 NE 103RD CT VANCOUVER, WA 98664 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $177 | $56 | $233 | 0.79% |
| PAMELA COPLE SMITH3 | 411 HIGHLAND DR SEATTLE, WA 98109 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $122 | — | $122 | 0.41% |
| DAVID KINNEY3 | 802 NEVADA DR LONGVIEW, WA 98632 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $84 | $15 | $99 | 0.33% |
| RAQUEL LOSADA MONROY3 | 817 NE DELP RD CAMAS, WA 98607 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $85 | $10 | $95 | 0.32% |
| ISAACSON INSURANCE AGENCY LLC3 | 1821 NW 23RD PL PORTLAND, OR 97210 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $46 | $12 | $58 | 0.20% |
| CAGNEY ERICKSON3 | 2105 NORRIS RD APT A13 VANCOUVER, WA 98661 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $19 | $31 | $50 | 0.17% |
| TY ROBERT NAUGLE3 | PO BOX 80273 PORTLAND, OR 97280 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $19 | $30 | $49 | 0.17% |
| ROXANA BUSCHMAN3 | 400 NE 149TH ST VANCOUVER, WA 98685 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $40 | — | $40 | 0.14% |
| TRICIA MILLER3 | 2101 NE 279TH ST RIDGEFIELD, WA 98642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $33 | — | $33 | 0.11% |
| KELLY ROSS SURGEON3 | 1419 28TH AVE STE B LEWISTON, ID 83501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | $9 | $17 | 0.06% |
| GABRIEL ANGEL CANALS3 | 1549 NW CIVIC DR APT 204 GRESHAM, OR 97030 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | $9 | $15 | 0.05% |
| DENISE A MAXWELL3 | 4273 E BELLINA LN MERIDIAN, ID 83642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | $1 | $9 | 0.03% |
| WENDY ELIZABETH WESOLOWSKI3 | 1284 N 12TH AVE PENSACOLA, FL 32503 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.02% |
| MELZER SUPPLEMENTAL BENEFITS INC3 | 4801 1 2 ELM AVE FORT PIERCE, FL 34982 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.01% |
| SOFIA JAMES DE LA CRUZ3 | 4237 IMPERIAL DR WEST LINN, OR 97068 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.01% |
| DELAREBA & FAM LLC3 | 8208 PRESTIGE COMMONS DR TAMARAC, FL 33321 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.01% |
| LYNN MARIE BARRY3 | 301 W PARK AVE LANGHOME, PA 19047 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| BROWN & BROWN INSURANCE SERVICES3 | 601 SW 2ND AVE, STE 1200 PORTLAND, OR 97204 | STANDARD INSURANCE COMPANY | $1K | — | $1K | 6.46% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN AND BROWN OF NY INC | 595 STEWART AVE STE 700 GARDEN CITY, NY 11530 | STANDARD INSURANCE COMPANY | $513 | — | $513 | 2.28% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN OF OREGON LLC | 2701 NW VAUGHN ST # 340 PORTLAND, OR 97296 | STANDARD INSURANCE COMPANY | $148 | — | $148 | 0.66% |
| BROWN & BROWN INSURANCE SERVICES3 | 601 SW 2ND AVE, STE 1200 PORTLAND, OR 97204 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 9.42% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN AND BROWN OF NY INC | 595 STEWART AVE STE 700 GARDEN CITY, NY 11530 | STANDARD INSURANCE COMPANY | $517 | — | $517 | 2.49% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN OF OREGON LLC | 2701 NW VAUGHN ST # 340 PORTLAND, OR 97296 | STANDARD INSURANCE COMPANY | $145 | — | $145 | 0.70% |
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 | 112 | 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) | 112 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 147 | $1.3M |
| Dental | DELTA DENTAL PLAN OF OREGON | 57 | $125K |
| Life insurance | STANDARD INSURANCE COMPANY | 112 | $21K |
| Short-term disability | STANDARD INSURANCE COMPANY | 112 | $22K |
| Long-term disability | STANDARD INSURANCE COMPANY | 112 | $54K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 160 | $36K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 160 | — |
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."
No prospect flags tripped on this filing.