| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PCF INSURANCE SERVICES OF THE WEST3 | 7150 SW HAMPTON ST STE 140 TIGARD, OR 97223 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $23K | $852 | $24K | 3.08% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: M&G INSURANCE AND RISK MANAGEMENT | 412 JEFFERSON PKWY STE 203 LAKE OSWEGO, OR 97035 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $13K | — | $13K | 3.10% |
| ALLIANCE BENEFITS SOLUTIONS, LLC3 | 391 RANDY DR GRANTS PASS, OR 97527 | TLIC | $11K | — | $11K | 17.02% |
| PCF INSURANCE SERVICES OF THE WEST3 | 2745 W 600 N LINDON, UT 84042 | TLIC | $8K | — | $8K | 12.58% |
| CASTRO MONROY GROUP, LLC3 | 2110 MISSION ST SE STE#305 SALEM, OR 97302 | TLIC | $19 | — | $19 | 0.03% |
| MARIA G VILLANUEVA3 | 1404 NW WALLACE RD MCMINNVILLE, OR 97128 | TLIC | $13 | — | $13 | 0.02% |
| BO B NYLEEN3 | 6455 13TH AVE SE SALEM, OR 97306 | TLIC | $7 | — | $7 | 0.01% |
| ANGEL X ESCAMILLA3 | 13787 SW FARMINGTON RD STE#228 BEAVERTON, OR 97005 | TLIC | $4 | — | $4 | 0.01% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: M&G INSURANCE AND RISK MANAGEMENT | 412 JEFFERSON PKWY STE 203 LAKE OSWEGO, OR 97035 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | $1K | — | $1K | 3.07% |
| PCF INSURANCE SERVICES OF THE WEST3 | 7150 SW HAMPTON ST STE 140 TIGARD, OR 97223 | SUN LIFE ASSURANCE COMPANY OF CANADA | $1K | — | $1K | 4.63% |
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 | 235 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 235 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 207 | $1.2M |
| Vision | SUN LIFE ASSURANCE COMPANY OF CANADA | 204 | $24K |
| Life insurance | TLIC | 140 | $63K |
| Other(2 contracts, 2 carriers) | TLIC | 398 | $72K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 398 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.