| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WORKSITE BENEFITS GROUP INC3 Filed as: WORKSITE BENEFITS GROUP, INC. | 112 NW 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8K | $12K | $20K | 15.85% |
| MARGARET BRYANT3 | 18014 BELMORE AVENUE LAKE OSWEGO, OR 97035 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13K | $4K | $17K | 13.90% |
| ISAACSON INSURANCE AGENCY LLC3 Filed as: ISAACSON INSURANCE AGENCY, LLC | 1250 11TH STREET WEST LINN, OR 97068 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13K | $4K | $17K | 13.52% |
| JD FULWILER AND COMPANY3 | 5727 SW MACADAM AVENUE PORTLAND, CA 97239 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17K | $0 | $17K | 13.50% |
| BENEFITS BY DESIGN INC3 Filed as: BENEFITS BY DESIGN, INC. | 2101 NE 279TH STREET RIDGEFIELD, WA 98642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $3K | $8K | 6.24% |
| CHRISTINE LYNN MORGESTER3 | 14913 SOUTH SUNTERRA LOOP OREGON CITY, OR 97045 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7K | $241 | $7K | 5.77% |
| CONSUMER DRIVEN BENEFITS LLC3 Filed as: CONSUMER DRIVEN BEN. & OTHER AGENTS | 1301 DOVE STREET NEWPORT BEACH, CA 92660 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $19 | $14 | $33 | 0.03% |
| JD FULWILER AND COMPANY3 | 5727 SW MACADAM AVENUE PORTLAND, OR 97239 | OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON | $3K | $0 | $3K | 4.54% |
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 | 4 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 122 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON | 127 | $64K |
| Life insurance | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 99 | $125K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 99 | $125K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 107 | $10K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 107 | $136K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 127 | — |
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.