| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AKT BENEFIT ADVISORS LP3 | 680 HAWTHORNE AVE SE #140 SALEM, OR 97301 | LIFEWISE HEALTH PLAN OF WASHINGTON | — | $453 | $453 | 0.27% |
| SIMPLIFY INSURANCE LLC3 Filed as: SIMPLIFY BENEFITS INC | 650 HOLLADAY ST STE 1600 PORTLAND, OR 97232 | AFLAC | $14K | $0 | $14K | 15.63% |
| MICHAEL C WALKER3 Filed as: MICHAEL M STASTNY | 650 HOLLADAY ST STE 1600 PORTLAND, OR 97232 | AFLAC | $6K | $997 | $7K | 8.08% |
| PAUL LANGAS3 | 700 N HAYDEN ISLAND DR STE 220 PORTLAND, OR 97217 | AFLAC | $3K | $0 | $3K | 2.99% |
| VIRGINIA L KNOPSKI3 | 17001 MILL LN LONG BEACH, WA 98631 | AFLAC | $409 | $381 | $790 | 0.90% |
| BRIAN L HUGGER3 | 10117 SE SUNNYSIDE RD STE F52 CLACKAMAS, OR 97015 | AFLAC | $178 | $352 | $530 | 0.60% |
| MATTHEW G BERGER3 Filed as: MATTHEW BUMALA | 14415 NW 25TH CT VANCOUVER, WA 98685 | AFLAC | $308 | $0 | $308 | 0.35% |
| IOANNIS T GRATSINOPOULOS3 | 3565 SUMMERLINN DR WEST LINN, OR 97068 | AFLAC | $223 | $29 | $252 | 0.29% |
| MATTHEW G BERGER3 Filed as: MATTHEW SHROYER | 7407 N WILLIAMS AVE PORTLAND, OR 97217 | AFLAC | $25 | $0 | $25 | 0.03% |
| CAMERON CARRILLO3 | 22556 SW 96TH DR TUALATIN, OR 97062 | AFLAC | $23 | $0 | $23 | 0.03% |
| KENNON PARKER3 | PO BOX 1121 OREGON CITY, OR 97045 | AFLAC | $13 | $0 | $13 | 0.01% |
| TERRY ANN PARKER3 | 11175 SW BERLIN AVE WILSONVILLE, OR 97070 | AFLAC | $13 | $0 | $13 | 0.01% |
| ROLAND VALDES3 | 117 NE 150TH ST VANCOUVER, WA 98685 | AFLAC | $7 | $0 | $7 | 0.01% |
| CHRISTOPHER WALLACE HOFF3 | 121 ROCKY POINT CT ACWORTH, GA 30101 | AFLAC | $2 | $0 | $2 | 0.00% |
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 | 476 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 476 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | LIFEWISE HEALTH PLAN OF WASHINGTON | 285 | $169K |
| Dental(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 476 | $258K |
| Life insurance | AFLAC | 105 | $88K |
| Short-term disability | AFLAC | 105 | $88K |
| Prescription drug | LIFEWISE HEALTH PLAN OF WASHINGTON | 285 | $169K |
| Stop-loss / reinsurancereinsurance | LIFEWISE ASSURANCE COMPANY | 285 | $499K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 476 | — |
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."
No prospect flags tripped on this filing.