| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 SO. 8TH ST., STE. 700 MINNEAPOLIS, MN 55402 | REGENCE BLUECROSS BLUESHIELD OF OREGON | $40K | — | $40K | 5.48% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 SO. 8TH ST., STE. 700 MINNEAPOLIS, MN 55402 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $763 | $7K | 6.93% |
| MARGARET BRYANT3 | 18014 SW BELMORE AVE. LAKE OSWEGO, OR 97035 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $483 | $3K | 9.82% |
| MJ INSURANCE3 Filed as: KAREN KUNKLER | 1709 NW 45TH AVE. CAMAS, WA 98607 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $305 | $2K | 7.61% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 SO. 8TH ST., STE. 700 MINNEAPOLIS, MN 55402 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $286 | $2K | 6.09% |
| PREMIER WORKSITE SOLUTIONS INC3 Filed as: PREMIER WORKSITE SOLUTIONS INC. | 806 NW 79TH ST. VANCOUVER, WA 98665 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $446 | $369 | $815 | 2.87% |
| LARRY SHERWOOD & ASSOC INC3 | 10220 SW GREENBURG RD. PORTLAND, OR 97223 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $417 | — | $417 | 1.47% |
| BENEFITS BY DESIGN INC3 Filed as: BENEFITS BY DESIGN INC. | 2101 NE 279TH ST. RIDGEFIELD, WA 98642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $113 | $65 | $178 | 0.63% |
| HEARTSEASE LLC3 | 1521 NE 63RD AVE. HILLSBORO, OR 97124 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $38 | $29 | $67 | 0.24% |
| ZINA OSTER3 | 3153 FOREST DR. CHEYENNE, WY 82001 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $34 | — | $34 | 0.12% |
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 | 152 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 152 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | REGENCE BLUECROSS BLUESHIELD OF OREGON | 137 | $762K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 152 | $99K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 152 | $128K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 152 | $99K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 152 | $99K |
| Prescription drug | REGENCE BLUECROSS BLUESHIELD OF OREGON | 137 | $734K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 152 | $99K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 152 | — |
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.
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.