| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| J.L. JONES AND ASSOCIATES3 | 720 COUNTRY CLUB ROAD, SUITE 100 EUGENE, OR 97401 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $52K | $0 | $52K | 5.00% |
| PREMIER WORKSITE SOLUTIONS INC3 | 112 NW 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $407 | $4K | 2.64% |
| JEFFREY JONES3 Filed as: JEFFREY LEE JONES | 720 COUNTRY CLUB ROAD EUGENE, OR 97401 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $0 | $3K | 1.87% |
| MJ INSURANCE3 Filed as: KAREN KUNKLER AND VARIOUS AGENTS | 1709 NW 45TH AVENUE CAMAS, WA 98607 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $30 | $2K | 1.24% |
| MARGARET BRYANT3 | 18014 SW BELMORE AVENUE LAKE OSWEGO, OR 97035 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $83 | $2K | 0.92% |
| BENEFITS BY DESIGN INC3 | 2101 NE 279TH STREET RIDGEFIELD, WA 98642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $871 | $78 | $949 | 0.58% |
| DONALD C SAVOY INC3 Filed as: DONALD TERRY GOTHAM | 3129 ECLIPSE DRIVE GREEN BAY, WI 54311 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $625 | $0 | $625 | 0.38% |
| ZINA OSTER3 | 3153 FOREST DRIVE CHEYENNE, WY 82001 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $547 | $0 | $547 | 0.33% |
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 | 0 | 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) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,667 | $1.0M |
| Short-term disability(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,667 | $1.2M |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,667 | $1.0M |
| Other(3 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 6,000 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 6,000 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.