| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DAVIDSON BENEFITS PLANNING LLC3 | 7632 SW DURHAM RD, STE 115 TIGARD, OR 97224 | REGENCE BLUECROSS BLUESHIELD OF OREGON | $1K | — | $1K | 0.01% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE | P.O. BOX 29 SPRINGFIELD, OR 97477 | REGENCE BLUECROSS BLUESHIELD OF OREGON | $880 | — | $880 | 0.01% |
| MONTGOMERY & GRAHAM INC3 Filed as: MONTGOMERY & GRAHAM, INC. | 412 JEFFERSON PKY, STE 100 LAKE OSWEGO, OR 97035 | REGENCE BLUECROSS BLUESHIELD OF OREGON | $820 | — | $820 | 0.01% |
| LARRY SHERWOOD & ASSOCIATES INC3 Filed as: LARRY SHERWOOD & ASSOCIATES | 10220 SW GREENBURG RD, STE 225 PORTLAND, OR 97223 | REGENCE BLUECROSS BLUESHIELD OF OREGON | $378 | — | $378 | 0.00% |
| WALTZ SHERIDAN CRAWFORD INC.3 | P.O. BOX 128 FOREST GROVE, OR 97116 | REGENCE BLUECROSS BLUESHIELD OF OREGON | $84 | — | $84 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BROWN & BROWN OF WA, INC DBA DIMART EIN 91-0378940 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Consulting (general); Insurance services; Insurance brokerage commissions and fees; Finders' fees / placement fees; Consulting fees; Insurance agents and brokers; Direct payment from the plan Service code 15 | — | $298K |
| VIGILANT SERVICES, INC. EIN 93-0877675 SUBSIDIARY OF SPONSOR | Finders' fees / placement fees; Direct payment from the plan; Consulting fees; Recordkeeping and information management (computing, tabulating, data processing, etc.); Consulting (general); Insurance services; Contract Administrator; Insurance brokerage commissions and fees; Insurance agents and brokers Service code 13 | — | $197K |
| ALDRICH BENEFITS AKT BENEFIT ADV LP EIN 20-0407135 NONE | Direct payment from the plan; Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | — | $195K |
| BENEFIT SOLUTIONS, INC. EIN 91-1603312 NONE | Contract Administrator; Participant communication; Recordkeeping and information management (computing, tabulating, data processing, etc.); Recordkeeping fees; Accounting (including auditing); Direct payment from the plan; Copying and duplicating Service code 10 | — | $140K |
| HART INSURANCE EIN 93-0519035 NONE | Insurance brokerage commissions and fees; Insurance agents and brokers; Direct payment from the plan Service code 22 | — | $55K |
| COMPENSATIONS SYSTEMS NW, INC EIN 42-1667380 NONE | Direct payment from the plan; Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | — | $46K |
| MJI INSURANCE/ HAGAN HAMILTON EIN 93-1067008 NONE | Insurance agents and brokers; Insurance brokerage commissions and fees; Direct payment from the plan Service code 22 | — | $36K |
| MONTGOMERY & GRAHAM, INC. EIN 91-1819536 NONE | Insurance brokerage commissions and fees; Insurance agents and brokers; Direct payment from the plan Service code 22 | — | $21K |
| LARRY SHERWOOD & ASSOCIATES EIN 93-0973312 NONE | Direct payment from the plan; Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | — | $15K |
| SCHOEDEL & SCHOEDEL, CPAS, PLLC EIN 91-0614823 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $14K |
| WARD INSURANCE EIN 93-0963467 NONE | Direct payment from the plan; Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | — | $11K |
| KPD INSURANCE, INC. EIN 93-0843355 NONE | Insurance agents and brokers; Insurance brokerage commissions and fees; Direct payment from the plan Service code 22 | — | $11K |
| BCI GROUP EIN 91-1180126 NONE | Direct payment from the plan; Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | — | $11K |
| BUSINESS INSURANCE NW, LLC EIN 45-3533969 NONE | Insurance agents and brokers; Insurance brokerage commissions and fees; Direct payment from the plan Service code 22 | — | $10K |
| PACIFIC CASCADE ADVISORS DBA GOLSAN EIN 91-1843783 NONE | Direct payment from the plan; Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | — | $7K |
| WHA INSURANCE/WILSON HEIRGOOD ASSOC EIN 93-0753180 NONE | Insurance agents and brokers; Direct payment from the plan; Insurance brokerage commissions and fees Service code 22 | — | $6K |
| LAPORTE & ASSOCIATES, INC. EIN 93-0775110 NONE | Insurance agents and brokers; Insurance brokerage commissions and fees; Direct payment from the plan Service code 22 | — | $6K |
| BROWN & BROWN NORTHWEST INSURANCE EIN 93-0518576 NONE | Insurance brokerage commissions and fees; Insurance agents and brokers; Direct payment from the plan Service code 22 | — | $6K |
| AMERIFLEX EIN 27-2256926 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Recordkeeping fees; Copying and duplicating; Participant communication; Accounting (including auditing); Direct payment from the plan; Contract Administrator Service code 10 | — | $5K |
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 | 2,125 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 2,125 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | REGENCE BLUECROSS BLUESHIELD OF OREGON | 3,213 | $13.4M |
| Dental | DELTA DENTAL PLAN OF OREGON (MODA) | 955 | $520K |
| Vision | REGENCE BLUECROSS BLUESHIELD OF OREGON | 3,213 | $13.4M |
| Prescription drug | REGENCE BLUECROSS BLUESHIELD OF OREGON | 3,213 | $13.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,213 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
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.