| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RICHARD J SKAYHAN3 | 5201 SOUTHWEST WESTGATE DRIVE SUITE 300 PORTLAND, OR 97221 | PACIFICSOURCE HEALTH PLANS | $84K | — | $84K | 4.62% |
| LEONARD ADAMS INSURANCE INC3 | 5201 SOUTHWEST WESTGATE DRIVE SUITE 300 PORTLAND, OR 97221 | AMERITAS LIFE INSURANCE CORP. | $6K | $540 | $6K | 5.49% |
| LEONARD ADAMS INSURANCE INC3 Filed as: LEONARD ADAMS COMPANY | 5201 SOUTHWEST WESTGATE DRIVE SUITE 300 PORTLAND, OR 97221 | VISION SERVICE PLAN | $1K | — | $1K | 6.19% |
| ENROLLEASE3 Filed as: ENROLLEASE, INC DBA EASECENTRAL | 1980 FESTIVAL PLAZA DRIVE SUITE 810 LAS VEGAS, NV 89135 | VISION SERVICE PLAN | $287 | — | $287 | 1.47% |
| 5 PEAKS SOLUTIONS LLC3 | 12938 HONEY LANE MT VERNON, WA 98374 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $811 | — | $811 | 6.30% |
| FAIRBANKS INSURANCE AGENCY INC3 | 20915 SOUTHWEST PACIFIC HIGHWAY SUITE D SHERWOOD, OR 97140 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $128 | — | $128 | 0.99% |
| AGENCY INSURANCE CONSULTANTS INC3 | 22315 7TH AVENUE SOUTH SOUTH DES MOINES, WA 98198 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $49 | — | $49 | 0.38% |
| SCHAFF TRACY3 | 5904 36TH AVENUE EAST TACOMA, WA 98443 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $9 | — | $9 | 0.07% |
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 | 219 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 75 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 294 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PACIFICSOURCE HEALTH PLANS | 219 | $1.8M |
| Dental | AMERITAS LIFE INSURANCE CORP. | 229 | $111K |
| Vision(2 contracts, 2 carriers) | AMERITAS LIFE INSURANCE CORP. | 229 | $131K |
| Other | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 23 | $13K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 229 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.