| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LEONARD ADAMS INSURANCE INC3 | 9400 SW BEAVERTON-HILLSDALE HIGHWAY SUITE 100 PORTLAND, OR 97225 | UNITEDHEALTHCARE INSURANCE COMPANY | $7K | $73K | $80K | 3.17% |
| LEONARD ADAMS INSURANCE INC3 | 5201 SW WESTGATE DRIVE SUITE 300 PORTLAND, OR 97221 | UNITEDHEALTHCARE INSURANCE COMPANY | $10K | — | $10K | 13.11% |
| 5 PEAKS SOLUTIONS LLC3 | 8904 FRANCES FOLSOM STSW LAKEWOOD, WA 98499 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $445 | — | $445 | 6.30% |
| FAIRBANKS INSURANCE AGENCY INC3 | 22331 SOUTHWEST PINE STREET SHERWOOD, OR 97140 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $88 | — | $88 | 1.24% |
| AGENCY INSURANCE CONSULTANTS INC3 | 1905 BRIDGEPORT WAY SUITE 106 UNIVERSITY PLACE, WA 98466 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $22 | — | $22 | 0.31% |
| SCHAFF TRACY3 | 5904 36TH AVENUE EAST TACOMA, WA 98443 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $4 | — | $4 | 0.06% |
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 | 261 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 263 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 377 | $2.5M |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 377 | $2.5M |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 377 | $2.5M |
| Life insurance | UNITEDHEALTHCARE INSURANCE COMPANY | 170 | $77K |
| Other(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 170 | $84K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 377 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.