| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI NORTHWEST | 700 NE MULTNOMAH, SUITE 1300 PORTLAND, OR 97232 | PRINCIPAL LIFE INSURANCE COMPANY | $8K | — | $8K | 5.11% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62949 VIRGINIA BEACH, VA 23466 | PRINCIPAL LIFE INSURANCE COMPANY | $6K | — | $6K | 3.75% |
| USI INSURANCE SERVICES LLC3 Filed as: USI NORTHWEST | 700 NE MULTNOMAH, SUITE 1300 PORTLAND, OR 97232 | VISION SERVICE PLAN | $2K | — | $2K | 3.00% |
| HEARTSEASE LLC3 Filed as: HEARTSEASE, LLC | 1521 NE 63RD AVENUE HILLSBORO, OR 97124 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $1K | $4K | 8.83% |
| USI INSURANCE SERVICES LLC3 Filed as: USI NORTHWEST | 700 NE MULTNOMAH, SUITE 1300 PORTLAND, OR 97232 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | — | $4K | 8.45% |
| MJ INSURANCE3 Filed as: JOHN K. CORNETT AND VARIOUS AGENTS | 2069 NW PINOT COURT BEND, OR 97701 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $518 | $2K | 3.72% |
| BENEFITS BY DESIGN INC3 Filed as: BENEFITS BY DESIGN, INC | 2101 NE 279TH STREET RIDGEFIELD, WA 98642 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $410 | $2K | 3.17% |
| CHRISTINE LYNN MORGESTER3 | 9405 NE 100TH WAY VANCOUVER, WA 98662 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $178 | $1K | 2.59% |
| PREMIER WORKSITE SOLUTIONS INC3 Filed as: PREMIER WORKSITE SOLUTIONS, INC. | 806 NW 79TH STREET VANCOUVER, WA 98665 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $703 | $511 | $1K | 2.53% |
| ROXANA BUSCHMAN3 | 400 NE 149TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $686 | $96 | $782 | 1.63% |
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 | 1,042 | 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) | 1,042 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 979 | $73K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 1,341 | $165K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 1,341 | $165K |
| Other(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 1,341 | $213K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,341 | — |
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.