| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PFC INSURANCE SERVICES OF THE WEST3 | 412 JEFFERSON PARKWAY SUITE #203 LAKE OSWEGO, OR 97035 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $26K | — | $26K | 1.97% |
| CAPITAL FINANCIAL PLC3 Filed as: CAPITAL FINANCIAL, PLC | 14614 NORTH KIERLAND BOULEVARD SUITE N230 SCOTTSDALE, AZ 85254 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $18K | $20 | $19K | 1.40% |
| MONTGOMERY & GRAHAM INC3 Filed as: MONTGOMERY & GRAHAM, INC. | 412 JEFFERSON PARKWAY SUITE 100 LAKE OSWEGO, OR 97035 | PRINCIPAL LIFE INSURANCE COMPANY | $6K | $5K | $11K | 7.57% |
| CAPITAL FINANCIAL PLC3 | 14614 NORTH KIERLAND BOULEVARD SUITE N230 SCOTTSDALE, AZ 85254 | PRINCIPAL LIFE INSURANCE COMPANY | $5K | — | $5K | 3.31% |
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 | 266 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 266 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 266 | $1.3M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 195 | $147K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 195 | $147K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 195 | $147K |
| Other | PRINCIPAL LIFE INSURANCE COMPANY | 195 | $147K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 266 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.