| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | PO BOX 29018 PORTLAND, OR 97296 | AETNA LIFE INSURANCE CO. | — | $2K | $2K | 0.29% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 601 SW 2ND AVE SUITE 1200 PORTLAND, OR 97204 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $9K | $3K | $12K | 13.13% |
| HEARTSEASE LLC3 | 1521 NE 63RD AVE HILLSBORO, OR 97124 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $761 | $3K | 8.11% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF OREGON LLC | — | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $272 | $3K | 7.64% |
| WORKSITE BENEFITS GROUP INC3 | 112 NW 114TH ST VANCOUVER, WA 98685 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $367 | $538 | $905 | 2.75% |
| BENEFITS BY DESIGN INC3 | 2101 NE 279TH ST RIDGEFIELD, WA 98642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $426 | $96 | $522 | 1.59% |
| JEFFREY DEAN SHIPMAN3 | 17072 SW KINGLET DRIVE SHERWOOD, OR 97140 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $150 | — | $150 | 0.46% |
| CASEY RATHMANNER3 | 310 HUCKLEBERRY LAKE FOREST, CA 92630 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $93 | — | $93 | 0.28% |
| QUEST BENEFITS NORTHWEST LLC3 | 2189 SOUTHEAST 12TH AVE CANBY, OR 97013 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $55 | — | $55 | 0.17% |
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 | 130 | 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) | 130 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE CO. | 101 | $648K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 130 | $95K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 130 | $95K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 130 | $95K |
| Prescription drug | AETNA LIFE INSURANCE CO. | 101 | $648K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 130 | $128K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 130 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.