| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF OREGON LLC | PO BOX 743061 LOS ANGELES, CA 90074 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $17K | $442 | $17K | 2.53% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF OREGON LLC | 601 SW 2ND AVE SUITE 1200 PORTLAND, OR 97204 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $11K | — | $11K | 10.13% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN SERVICES OF CA | — | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | — | $4K | $4K | 3.67% |
| HEARTSEASE LLC3 | 1521 NE 63RD AVE HILLSBORO, OR 97124 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $1K | $4K | 10.83% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF OREGON LLC | — | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $380 | $3K | 8.33% |
| WORKSITE BENEFITS GROUP INC3 | 112 NW 114TH ST VANCOUVER, WA 98685 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $494 | $498 | $992 | 2.68% |
| BENEFITS BY DESIGN INC3 | 2101 NE 279TH ST RIDGEFIELD, WA 98642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $537 | $143 | $680 | 1.84% |
| JEFFREY DEAN SHIPMAN3 | 17072 SW KINGLET DRIVE SHERWOOD, OR 97140 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $191 | — | $191 | 0.52% |
| CASEY RATHMANNER3 | 1601 NE CRESTVIEW LN CORBETT, OR 97019 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $114 | — | $114 | 0.31% |
| QUEST BENEFITS NORTHWEST LLC3 | 2189 SOUTHEAST 12TH AVE CANBY, OR 97013 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $65 | — | $65 | 0.18% |
| ISAACSON INSURANCE AGENCY LLC3 | 1250 11TH ST WEST LINN, OR 97068 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $63 | — | $63 | 0.17% |
| MICHAEL LEROY ALLEY3 | 2189 SE 12TH AVE CANBY, OR 97013 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $40 | — | $40 | 0.11% |
| SUSAN J LEACH3 | 4419 NE 131ST PL APT C1 PORTLAND, OR 97230 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $37 | — | $37 | 0.10% |
| KAREN CLAY KUNKLER3 | 415 SE 177TH AVE UNIT 236 VANCOUVER, WA 98683 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.01% |
| ROXANA BUSCHMAN3 | 400 NE 149TH ST VANCOUVER, WA 98685 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.01% |
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 | 118 | 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) | 118 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 99 | $683K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 118 | $108K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 118 | $108K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 118 | $108K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 99 | $683K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 118 | $145K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 118 | — |
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.