| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| IMA, INC.3 | PO BOX 1657 SPRINGFIELD, OR 97477 | PROVIDENCE HEALTH PLAN | $36K | — | $36K | 3.00% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE, LLC | 1111 GATEWAY LOOP SPRINGFIELD, OR 97477 | WILLAMETTE DENTAL INSURANCE, INC. | $2K | $0 | $2K | 5.00% |
| IMA, INC.3 | 1111 GATEWAY LOOP SPRINGFIELD, OR 97477 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $5K | $0 | $5K | 9.97% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE, LLC | 1111 GATEWAY LOOP SPRINGFIELD, OR 97477 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 8.02% |
| ZARA ANNE PINES3 | 9010 SW OAK STREET APARTMENT 300A PORTLAND, OR 97223 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $400 | $0 | $400 | 1.65% |
| WORKSITE BENEFITS GROUP INC3 Filed as: WORKSITE BENEFITS GROUP, INC. | 112 NW 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $203 | $0 | $203 | 0.84% |
| BENEFITS BY DESIGN INC3 Filed as: BENEFITS BY DESIGN, INC. | 2101 NE 279TH STREET RIDGEFIELD, WA 98642 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $168 | $0 | $168 | 0.69% |
| ISAACSON INSURANCE AGENCY LLC3 Filed as: ISAACSON INSURANCE AGENCY, LLC | 1821 NW 23RD PLACE PORTLAND, OR 97210 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $118 | $0 | $118 | 0.49% |
| MARGARET BRYANT3 | 18014 BELMORE AVENUE LAKE OSWEGO, OR 97035 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $71 | $0 | $71 | 0.29% |
| ZINA OSTER3 Filed as: ZINA OSTER AND OTHER AGENTS | 1317 EDGEWATER DRIVE, SUITE 5766 ORLANDO, FL 32804 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $16 | $0 | $16 | 0.07% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE, LLC | 1111 GATEWAY LOOP SPRINGFIELD, OR 97477 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $0 | $2K | 13.69% |
| WATCHTOWER BENEFITS, LLC3 | 306 WEST ERIE STREET, SUITE 300 CHICAGO, IL 60654 | METROPOLITAN LIFE INSURANCE COMPANY | $149 | $0 | $149 | 1.00% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE, LLC | PO BOX 784 SPRINGFIELD, OR 97477 | VISION SERVICE PLAN | $843 | $0 | $843 | 6.68% |
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 | 138 | 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) | 138 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PROVIDENCE HEALTH PLAN | 182 | $1.2M |
| Dental(2 contracts, 2 carriers) | WILLAMETTE DENTAL INSURANCE, INC. | 116 | $94K |
| Vision | VISION SERVICE PLAN | 116 | $13K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 44 | $39K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 26 | $24K |
| Prescription drug | PROVIDENCE HEALTH PLAN | 182 | $1.2M |
| Other(3 contracts, 3 carriers) | PROVIDENCE HEALTH PLAN | 182 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 182 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.