| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF WASHINGTON INC. | 1501 FOURTH AVENUE, SUITE 2400 SEATTLE, WA 98101 | REGENCE BLUECROSS BLUESHIELD OF OREGON | $158 | — | $158 | 0.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | — | MODA HEALTH | $6K | — | $6K | 1.00% |
| AKT BENEFIT ADVISORS LP3 | 680 HAWTHORNE AVE SE, SUITE 140 SALEM, OR 97301 | MODA HEALTH | $5K | — | $5K | 0.79% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | — | MODA HEALTH | $482 | — | $482 | 0.08% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AKT BENEFIT ADVISORS, LP EIN 20-0407135 NONE | Consulting (general); Insurance brokerage commissions and fees; Consulting fees; Recordkeeping and information management (computing, tabulating, data processing, etc.); Finders' fees / placement fees; Direct payment from the plan; Insurance services; Insurance agents and brokers Service code 15 | — | $251K |
| VIGILANT SERVICES, INC. EIN 93-0877675 SUBSIDIARY OF SPONSOR | Insurance services; Consulting (general); Insurance agents and brokers; Consulting fees; Insurance brokerage commissions and fees; Finders' fees / placement fees; Contract Administrator; Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 13 | — | $185K |
| BENEFIT SOLUTIONS, INC. EIN 91-1603312 NONE | Participant communication; Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Accounting (including auditing); Recordkeeping fees; Copying and duplicating; Contract Administrator Service code 10 | — | $133K |
| BROWN & BROWN OF WA, INC DBA DIMART EIN 91-0378940 NONE | Finders' fees / placement fees; Direct payment from the plan; Consulting (general); Recordkeeping and information management (computing, tabulating, data processing, etc.); Insurance agents and brokers; Insurance brokerage commissions and fees; Insurance services; Consulting fees Service code 15 | — | $63K |
| COMPENSATION SYSTEMS NW, INC EIN 42-1667380 NONE | Insurance brokerage commissions and fees; Insurance agents and brokers; Direct payment from the plan Service code 22 | — | $45K |
| MJI INSURANCE/ HAGAN HAMILTON EIN 93-1067008 NONE | Direct payment from the plan; Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | — | $26K |
| HART INSURANCE EIN 93-0519035 NONE | Insurance brokerage commissions and fees; Direct payment from the plan; Insurance agents and brokers Service code 22 | — | $24K |
| BCI GROUP EIN 91-1180126 NONE | Insurance agents and brokers; Direct payment from the plan; Insurance brokerage commissions and fees Service code 22 | — | $18K |
| LARRY SHERWOOD & ASSOCIATES NONE | Insurance agents and brokers; Direct payment from the plan; Insurance brokerage commissions and fees Service code 22 | 10220 SW GREENBURG RD, SUITE 225 PORTLAND, OR 97223 | $10K |
| CASCADE SUMMIT INSURANCE EIN 45-5393247 NONE | Insurance agents and brokers; Direct payment from the plan; Insurance brokerage commissions and fees Service code 22 | — | $9K |
| WHA INSURANCE NONE | Insurance brokerage commissions and fees; Insurance agents and brokers; Direct payment from the plan Service code 22 | 2930 CHAD DR EUGENE, OR 97408 | $9K |
| BUSINESS INSURANCE NW, LLC EIN 45-3533969 NONE | Direct payment from the plan; Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | — | $7K |
| MONTGOMERY & GRAHAM, INC. EIN 91-1819536 NONE | Insurance agents and brokers; Insurance brokerage commissions and fees; Direct payment from the plan Service code 22 | — | $6K |
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 | 2,886 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 2,886 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | REGENCE BLUECROSS BLUESHIELD OF OREGON | 2,893 | $13.0M |
| Dental | MODA HEALTH | 2,195 | $573K |
| Vision | REGENCE BLUECROSS BLUESHIELD OF OREGON | 2,893 | $13.0M |
| Prescription drug | REGENCE BLUECROSS BLUESHIELD OF OREGON | 2,893 | $13.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,893 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.