| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | STANDARD INSURANCE COMPANY | $4K | $520 | $4K | 4.86% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | STANDARD INSURANCE COMPANY | $0 | $701 | $701 | 0.79% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE, SUITE 200 BELLEVUE, WA 98004 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $0 | $6K | 7.71% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $1K | $1K | 1.61% |
| WATCHTOWER BENEFITS, LLC3 Filed as: WATCHTOWER TECHNOLOGIES, INC. | 306 WEST ERIE STREET, SUITE 300 CHICAGO, IL 60654 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 1.38% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE BELLEVUE, WA 98004 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $93 | $3K | 10.45% |
| BENEFITS BY DESIGN INC3 Filed as: BENEFITS BY DESIGN, INC. | 2101 NE 279TH STREET RIDGEFIELD, WA 98642 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $437 | $2K | 8.37% |
| WORKSITE BENEFITS GROUP INC3 Filed as: WORKSITE BENEFITS GROUP, INC. | 112 NW 114TH STREET VANCOUVER, WV 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $257 | $434 | $691 | 2.79% |
| ESSENTIAL OIL JOY3 | 2909 SOUTH HARPER VALLEY WAY RIDGEFIELD, WA 98642 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $209 | $6 | $215 | 0.87% |
| ROXANA BUSCHMAN3 Filed as: ROXANA BUSCHMAN & OTHER AGENTS | 400 NE 149TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $156 | $54 | $210 | 0.85% |
| AMY E COHEN3 Filed as: AMY E. COHEN | 19967 VILA LANTE PLACE BOCA RATON, FL 33434 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $172 | $17 | $189 | 0.76% |
| RAQUEL LOSADA MONROY3 | 817 NE DELP ROAD CAMAS, WA 98607 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $154 | $17 | $171 | 0.69% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | VISION SERVICE PLAN | $1K | — | $1K | 5.63% |
| EMPLOYEE NAVIGATOR, LLC3 | 7979 OLD GEORGETOWN ROAD, SUITE 300 BETHESDA, MD 20814 | VISION SERVICE PLAN | $5 | — | $5 | 0.02% |
| BENEFITS BY DESIGN INC3 Filed as: BENEFITS BY DESIGN, INC. | 2101 NE 279TH STREET RIDGEFIELD, WA 98642 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $615 | $2K | 12.93% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE BELLEVUE, WA 98004 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $118 | $2K | 10.64% |
| WORKSITE BENEFITS GROUP INC3 Filed as: WORKSITE BENEFITS GROUP, INC. | 112 NW 114TH STREET VANCOUVER, WV 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $225 | $527 | $752 | 4.38% |
| ESSENTIAL OIL JOY3 | 2909 SOUTH HARPER VALLEY WAY RIDGEFIELD, WA 98642 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $231 | $7 | $238 | 1.39% |
| ROXANA BUSCHMAN3 | 400 NE 149TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $105 | $0 | $105 | 0.61% |
| AMY E COHEN3 Filed as: AMY E. COHEN | 19967 VILA LANTE PLACE BOCA RATON, FL 33434 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $57 | $7 | $64 | 0.37% |
| RAQUEL LOSADA MONROY3 Filed as: RAQUEL LOSADA MONROY & OTHER AGENTS | 817 NE DELP ROAD CAMAS, WA 98607 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $22 | $14 | $36 | 0.21% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVENUE NE BELLEVUE, WA 98004 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $400 | $15 | $415 | 9.20% |
| BENEFITS BY DESIGN INC3 Filed as: BENEFITS BY DESIGN, INC. | 2101 NE 279TH STREET RIDGEFIELD, WA 98642 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $277 | $66 | $343 | 7.60% |
| WORKSITE BENEFITS GROUP INC3 Filed as: WORKSITE BENEFITS GROUP, INC. | 112 NW 114TH STREET VANCOUVER, WV 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $67 | $122 | $189 | 4.19% |
| ROXANA BUSCHMAN3 | 400 NE 149TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $76 | $0 | $76 | 1.68% |
| AMY E COHEN3 Filed as: AMY E. COHEN | 19967 VILA LANTE PLACE BOCA RATON, FL 33434 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $36 | $3 | $39 | 0.86% |
| MELLONEASE KIRKSEY3 | 1664 CEDAR SPRINGS COURT CLARKSVILLE, TN 37042 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $22 | $4 | $26 | 0.58% |
| PEAKCOCK FINANCIALS, INC.3 | 11830 NW 32ND MNR SUNRISE, FL 33323 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2 | $3 | $5 | 0.11% |
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 | 956 | 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) | 956 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | STANDARD INSURANCE COMPANY | 105 | $89K |
| Vision(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 107 | $110K |
| Life insurance(5 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 956 | $123K |
| Short-term disability(4 contracts) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 41 | $48K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 956 | $75K |
| Other(5 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 956 | $123K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 956 | — |
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.