| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TOWN & COUNTRY INSURANCE3 Filed as: TOWN & COUNTRY INSURANCE CENTER | 2638 TAHITIAN AVE MEDFORD, OR 97504 | HEALTH NET | $29K | — | $29K | 1.64% |
| WARD INSURANCE AGENCY INC3 | PO BOX 10167 EUGENE, OR 97440 | HEALTH NET | $13K | — | $13K | 0.76% |
| HAGEN HAMILTON INSURANCE3 | PO BOX 847 MCMINNVILLE, OR 97128 | HEALTH NET | $12K | — | $12K | 0.67% |
| AKT BENEFIT ADVISORS LP3 Filed as: AKT BENEFIT ADVISORS | 680 HAWTHORNE AVE SUITE 140 SALEM, OR 97301 | HEALTH NET | $6K | — | $6K | 0.35% |
| COMPENSATION SYSTEMS NORTHWEST, INC3 Filed as: COMPENSATION SYSTEMS NW INC | 2501 SW FIRST AVE SUITE 320 MCMINNVILLE, OR 97201 | HEALTH NET | $5K | — | $5K | 0.31% |
| OAK TREE INSURANCE INC3 | 5335 MEADOWS RD #101 LAKE OSWEGO, OR 97330 | HEALTH NET | $2K | — | $2K | 0.14% |
| WHA INSURANCE AGENCY INC3 | PO BOX 1421 EUGENE, OR 97440 | HEALTH NET | $2K | — | $2K | 0.12% |
| HUGGINS INSURANCE SERVICES, INC.3 Filed as: HUGGINS INSURANCE SERVICES INC | 1786 STATE ST SALEM, OR 97301 | HEALTH NET | $1K | — | $1K | 0.08% |
| BARKER-UERLINGS INSURANCE3 Filed as: BARKER UERLINGS INSURANCE | 340 NW 5TH ST CORVALLIS, OR 97330 | HEALTH NET | $30 | — | $30 | 0.00% |
| AKT BENEFIT ADVISORS LP3 | 680 HAWTHORNE ST SE SUITE 140 SALEM, OR 97301 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $17K | — | $17K | 5.69% |
| COMPENSATION SYSTEMS NORTHWEST, INC3 Filed as: COMPENSATION SYSTEMS NW INC | 2501 SW FIRST AVE SUITE 320 PORTLAND, OR 97201 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $6K | — | $6K | 2.04% |
| BERRY INSURANCE SERVICES LLC3 Filed as: BERRY INSURANCE AGENCY | 310 N STATE ST SUITE 22 LAKE OSWEGO, OR 97034 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $1K | — | $1K | 0.42% |
| ISU AZUMANO INSURANCE3 Filed as: ISU AZUMANO INSURANCE AGENCY | PO BOX 91459 PORTLAND, OR 97291 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $832 | — | $832 | 0.28% |
| JEFF MARCUM3 | 934 N HUMBOLDT PORTLAND, OR 97217 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $799 | — | $799 | 0.26% |
| GREENBERG & ASSOCIATES INSURANCE3 Filed as: GREENBERG AND ASSOCIATED INSURANCE | 3439 NE SANDY BLVD #378 PORTLAND, OR 97232 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $738 | — | $738 | 0.24% |
| PROPEL INSURANCE3 | 888 SW 5TH ST SUITE 1170 PORTLAND, OR 97204 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $368 | — | $368 | 0.12% |
| BARKER PHILLIPS JACKSON INC3 Filed as: BARKER | — | SAMARITAN HEALTH PLANS | $4K | — | $4K | 2.43% |
| AKT BENEFIT ADVISORS LP3 | 680 HAWTHORNE ST SE SUITE 140 SALEM, OR 97301 | SAMARITAN HEALTH PLANS | $2K | — | $2K | 1.21% |
| HAGEN HAMILTON INSURANCE3 | PO BOX 847 MCMINNVILLE, OR 97128 | SAMARITAN HEALTH PLANS | $1K | — | $1K | 0.61% |
| WARD INSURANCE AGENCY INC3 Filed as: WARD INSURANCE | PO BOX 1421 EUGENE, OR 97440 | SAMARITAN HEALTH PLANS | $126 | — | $126 | 0.08% |
| TOWN & COUNTRY INSURANCE3 Filed as: TOWN & COUNTRY INSURANCE CENTER | 2638 TAHITIAN AVE MEDFORD, OR 97501 | SAMARITAN HEALTH PLANS | $32 | — | $32 | 0.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CYPRESS BENEFIT ADMINISTRATORS EIN 39-1997579 NONE | Claims processing Service code 12 | — | $35K |
| AKT BENEFIT ADVISORS LP EIN 20-0407135 NONE | Insurance agents and brokers Service code 22 | — | $29K |
| MCCARTIN ANALYTICAL SERVICES EIN 03-8384655 NONE | Actuarial Service code 11 | — | $11K |
| ACUMEN FINANCIAL SERVICE GROUP EIN 20-0745610 NONE | Accounting (including auditing) Service code 10 | — | $8K |
| SCHWABE, WILLIAMSON & WYATT EIN 93-1130272 NONE | Legal Service code 29 | — | $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 | 860 | 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. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 860 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | HEALTH NET | 469 | $2.2M |
| Dental | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 71 | $302K |
| Vision(2 contracts, 2 carriers) | HEALTH NET | 469 | $2.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 469 | — |
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."
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.