| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MONTGOMERY & GRAHAM INC3 Filed as: MONTGOMERY & GRAHAM, INC | 412 JEFFERSON PKWY #100 LAKE OSWEGO, OR 97035 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $23K | $737 | $24K | 2.85% |
| MONTGOMERY & GRAHAM INC3 | — | OREGON DENTAL SERVICE DBA DELTA DENTAL OF OREGON | $4K | — | $4K | 3.59% |
| MONTGOMERY & GRAHAM INC3 Filed as: MONTGOMERY AND GRAHAM INC | 412 JEFFERSON PKWY STE 100 LAKE OSWEGO, OR 97035 | PRINCIPAL LIFE INSURANCE COMPANY | $7K | $3K | $10K | 14.78% |
| MARGARET BRYANT3 | 18014 SW BELMORE AVE LAKE OSWEGO, OR 97035 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $1K | $2K | 33.68% |
| MONTGOMERY & GRAHAM INC3 Filed as: MONTGOMERY AND GRAHAM INC | 412 JEFFERSON PKWY LAKE OSWEGO, OR 97035 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $860 | $53 | $913 | 12.37% |
| PREMIER WORKSITE SOLUTIONS INC3 | 112 NW 14TH ST VANCOUVER, WA 98685 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $256 | $351 | $607 | 8.23% |
| THOMAS TAYLOR3 Filed as: THOMAS MCKY TAYLOR | PO BOX 70334 SPRINGFIELD, OK 97475 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $72 | — | $72 | 0.98% |
| ZINA OSTER3 | 3153 FOREST DR CHEYENNE, WY 82001 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.15% |
| DAMON RAY OGIER3 | 1630 CARNAHAN DR #5 GRANTS PASS, OR 97527 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.08% |
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 | 188 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 188 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 400 | $825K |
| Dental | OREGON DENTAL SERVICE DBA DELTA DENTAL OF OREGON | 270 | $100K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 250 | $65K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 250 | $65K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 250 | $65K |
| Other | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 15 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 400 | — |
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.