| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LEAVITT GROUP3 Filed as: LEAVITT GROUP BENEFITS SERVICES INC | 7881 W CHARLESTON BLVD, SUITE 140 LAS VEGAS, NV 89117 | HEALTH PLAN OF NEVADA/SIERRA HEALTH & LIFE | $30K | $12K | $42K | 3.32% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE, INC. | PO BOX 29 SPRINGFIELD, OH 97477 | HEALTH PLAN OF NEVADA/SIERRA HEALTH & LIFE | $9K | — | $9K | 0.73% |
| WORLD INSURANCE ASSOCIATES LLC4 Filed as: KPD INSURANCE, INC. | PO BOX 29 SPRINGFIELD, OR 97477 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $31K | — | $31K | 7.41% |
| MARGARET BRYANT3 Filed as: MARGARET ISOBEL BRYANT | 18014 SW BELMORE AVE LAKE OSWEGO, OR 97035 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15K | $3K | $19K | 4.45% |
| PREMIER WORKSITE SOLUTIONS INC3 Filed as: PREMIER WORKSITE SOLUTIONS, INC. | 806 NW 79TH STREET VANCOUVER, WA 98665 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6K | $5K | $11K | 2.50% |
| KAREN CLAY KUNKLER3 | 1709 NW 45TH AVENUE CAMAS, WA 98607 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9K | $1K | $10K | 2.48% |
| CAROLE H WARREN3 Filed as: CAROLE H. WARREN | 1300 27TH PLACE SOUTH BIRMINGHAM, AL 35205 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $548 | $2K | 0.59% |
| MARK J ROBISON3 Filed as: MARK J. ROBISON | 1255 KIENAS ROAD KALISPELL, MT 59901 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $143 | $2K | 0.58% |
| PATRICIA MARTINEZ3 | 9572 WORLD CUP DR. LAS VEGAS, NE 89117 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $225 | $2K | 0.54% |
| CHRISTINE LYNN MORGESTER3 | 9405 NE 100TH WAY VANCOUVER, WA 98662 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $337 | $2K | 0.46% |
| KEVIN DALTON PINE3 | 168 WELLAND COURT LAS VEGAS, NV 89144 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 0.31% |
| BENEFITS BY DESIGN INC3 Filed as: BENEFITS BY DESIGN | 2101 NE 279TH ST. RIDGEFIELD, WA 98642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $717 | $442 | $1K | 0.28% |
| VIP INSURANCE INC3 Filed as: VIP INSURANCE, INC. | 400 SOUTH RAMPART BLVD., STE. 25 LAS VEGAS, NV 89145 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $680 | $433 | $1K | 0.26% |
| MARDEIO CANNON3 Filed as: MARDEIO MATTHEW CANNON | 5027 DYNASTY WAY SACRAMENTO, CA 95835 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $804 | $14 | $818 | 0.19% |
| LINDA WOODS3 | 3833 PALM ISLAND CT. LAS VEGAS, NE 89147 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $763 | $38 | $801 | 0.19% |
| ROXANA BUSCHMAN3 | 400 NORTHEAST 149TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $675 | $42 | $717 | 0.17% |
| ANNA L. HARRIS3 | 2451 OLD FORGE LANE LAS VEGAS, NV 89121 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $650 | — | $650 | 0.15% |
| DARL CORNMAN3 | 18399 SW 133RD TERRACE TUALATIN, OR 97062 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $470 | $100 | $570 | 0.14% |
| JASON STUBBS3 | PO BOX 867 CRESWELL, OR 97426 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $487 | $3 | $490 | 0.12% |
| ZINA OSTER3 | 3153 FOREST DR. CHEYENNE, WY 82001 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $466 | — | $466 | 0.11% |
| JAN N HEIMBAUGH3 Filed as: JAN MYERS | 810 NE HOLLY ST. MYRTLE CREEK, OR 97457 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $424 | $25 | $449 | 0.11% |
| SUSAN J LEACH3 Filed as: SUSAN J. LEACH | 4419 NE 131ST PLACE PORTLAND, OR 97230 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $390 | $41 | $431 | 0.10% |
| MARY ESTHER TAYLOR3 | 1126 GATEWAY LOOP SPRINGFIELD, OR 97477 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $382 | $13 | $395 | 0.09% |
| PAUL SCOTT MORRIS3 | 5272 S. SWEETGRASS WAY BOISE, ID 83716 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $379 | $12 | $391 | 0.09% |
| DEREK THURSTON3 | 112 NW 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $366 | $11 | $377 | 0.09% |
| JOHN KEVIN CORNETT3 | 2069 NW PINOT CT. BEND, OR 97701 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $172 | $193 | $365 | 0.09% |
| LARRY P HILDEBRANDT3 Filed as: LARRY KENNETH GRIFFIN | 33 N. CENTRAL AVE., #429 MEDFORD, OR 97501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $84 | $173 | $257 | 0.06% |
| BENEFITTING YOU INC3 Filed as: BENEFITTING YOU,INC. | 2497 CITRUS GARDEN CIRCLE HENDERSON, NV 89052 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $103 | $81 | $184 | 0.04% |
| TODD BOOZER3 Filed as: TODD A. BOOZER | 2900 CAHABA ROAD BIRMINGHAM, AL 35223 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $86 | $83 | $169 | 0.04% |
| JEFFREY TATHWELL3 | 1521 SE 63RD AVE. HILLSBORO, OR 97124 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $166 | — | $166 | 0.04% |
| DONALD C SAVOY INC3 Filed as: DONALD TERRY GOTHAM | 3129 ECLIPSE DR. GREEN BAY, WI 54311 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $165 | — | $165 | 0.04% |
| KLD INSURANCE BENEFITS INC3 Filed as: KLD INSURANCE BENEFITS, INC. | 9085 BETHEL RD. GAINESVILLE, GA 30506 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $60 | $74 | $134 | 0.03% |
| RITA J ROBINSON3 Filed as: RITA J. ROBINSON | 21780 WILLAMETTE DRIVE WEST LINN, OR 97068 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $58 | $74 | $132 | 0.03% |
| JEFF EDWARDS3 | 20845 NW KACHINA AVE. REDMOND, OR 97756 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $130 | — | $130 | 0.03% |
| DARYL W. VIDOR3 | 104 PIONEER DR. FOLSOM, CA 95630 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $71 | $55 | $126 | 0.03% |
| NORMAC SOLUTIONS INC3 Filed as: NORMAC SOLUTIONS, INC. | 3730 EVEREST DR. MONTGOMERY, AL 36106 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $60 | $33 | $93 | 0.02% |
| D'ARCIPRETE & ASSOCIATES INC3 Filed as: D'ARCIPRETE & ASSOCIATES, INC. | 12945 US HIGHWAY 331 MONTGOMERY, AL 36105 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $31 | $62 | $93 | 0.02% |
| NORTHROP AND ASSOCIATES3 | 2505 ANTHEM VILLAGE DRIVE HENDERSON, NV 89052 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $57 | $13 | $70 | 0.02% |
| PATRICIA MELNIK3 | 13770 SW 21ST ST. BEAVERTON, OR 97008 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $65 | — | $65 | 0.02% |
| DENISE A MAXWELL3 Filed as: DENISE A. MAXWELL | 5475 N. MITHCUM AVE. MERIDIAN, ID 83646 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $29 | $36 | $65 | 0.02% |
| MARY BROOK FORD3 | 5475 N. MITHCUM AVE. MERIDIAN, ID 83646 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $29 | $36 | $65 | 0.02% |
| HEARTSEASE LLC3 | 1521 NE 63RD AVE. HILLSBORO, OR 97124 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $54 | $9 | $63 | 0.01% |
| AK VARGASON & ASSOCIATES3 | 13382 SW MACBETH DR. TIGARD, OR 97224 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $52 | — | $52 | 0.01% |
| CENTURY INSURANCE GROUP LLC3 Filed as: CENTURY INSURANCE GROUP, LLC | 815 SW BOND ST., STE. 130 BEND, OR 97702 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $31 | $18 | $49 | 0.01% |
| DONALD C SAVOY INC3 Filed as: DONALD TERRY GOTHAM | 4009 N 9TH ST. TACOMA, WA 98406 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $49 | — | $49 | 0.01% |
| JULIA GEORGE3 Filed as: JULIA GESZ | 400 SOUTH RAMPART BLVD., STE. 25 LAS VEGAS, NV 89145 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $36 | — | $36 | 0.01% |
| BRANDON NORIEGA-ARANA3 | 22075 CAMELLIA AVE. NE AURORA, OR 97002 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $31 | $2 | $33 | 0.01% |
| JONATHAN MATTHEW CANNON3 | 6301 LIVORNO WAY ELK GROVE, CA 95757 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | $8 | $22 | 0.01% |
| WARREN LEE RUND3 | 7395 OFFENHAUSER DR. RENO, NV 89511 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20 | — | $20 | 0.00% |
| LUCIANO BORTOLETTO3 | 7938 AUBURN OAKS VILLAGE LANE CITRUS HEIGHTS, CA 95610 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | — | $16 | 0.00% |
| WELLS FARGO INSURANCE SERVICES3 | 1300 SW. 5TH AVE. PORTLAND, OR 97201 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | — | $13 | 0.00% |
| BETH MATHIAS-KUHL3 Filed as: BETH M. KUHL | 2031 SHATTO DRIVE BELGRADE, ME 59714 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | — | $9 | 0.00% |
| MJ INSURANCE3 Filed as: H. WARD | PACIFIC BENEFIT PLANNING LAKE OSWEGO, OR 97035 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.00% |
| DANIEL M. BRADLEY3 | 6125 ELKHORN RD. LAS VEGAS, NV 89131 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.00% |
| SHEILAH RUND3 | 7395 OFFENHAUSER DR. RENO, NV 89511 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.00% |
| BENEFIT CONSULTANTS INC3 Filed as: BENEFIT CONSULTANTS, INC. | 2105 VESTIVIA LAKE DRIVE BIRMINGHAM, AL 35216 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| PAM BRUNING3 | 1430 W. CASINO RD. EVERETT, WA 98204 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| KEVIN LEE SURLES SR3 Filed as: KEVIN LEE SURLES | 1054 VILLA MARIA COURT SAN JOSE, CA 95125 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE INC | PO BOX 784 SPRINGFIELD, OR 97477 | STANDARD INSURANCE COMPANY | $7K | — | $7K | 4.24% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE INC | PO BOX 784 SPRINGFIELD, OR 97477 | STANDARD INSURANCE COMPANY | $5K | — | $5K | 4.48% |
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 | 1,575 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 15 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,590 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTH PLAN OF NEVADA/SIERRA HEALTH & LIFE | 280 | $1.3M |
| Dental | HEALTH PLAN OF NEVADA/SIERRA HEALTH & LIFE | 280 | $1.3M |
| Vision | HEALTH PLAN OF NEVADA/SIERRA HEALTH & LIFE | 280 | $1.3M |
| Life insurance(3 contracts, 3 carriers) | HEALTH PLAN OF NEVADA/SIERRA HEALTH & LIFE | 949 | $1.8M |
| Short-term disability(2 contracts, 2 carriers) | HEALTH PLAN OF NEVADA/SIERRA HEALTH & LIFE | 509 | $1.7M |
| Long-term disability | STANDARD INSURANCE COMPANY | 817 | $174K |
| Prescription drug | HEALTH PLAN OF NEVADA/SIERRA HEALTH & LIFE | 280 | $1.3M |
| Other | STANDARD INSURANCE COMPANY | 817 | $174K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 949 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.