| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CU BENEFITS ALLIANCE3 | 1500 NW BETHANY BLVD 330 BEAVERTON, OR 97006 | DELTA DENTAL OF OREGON | $4K | — | $4K | 3.54% |
| CU BENEFITS ALLIANCE3 | 451 DIVISION ST NE SALEM, OR 97301 | WILLAMETTE DENTAL INSURANCE INC | $5K | — | $5K | 5.00% |
| CU BENEFITS ALLIANCE3 | PO BOX 12398 SALEM, OR 97309 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 10.00% |
| CU BENEFITS ALLIANCE3 | PO BOX 12398 SALEM, OR 97309 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 10.00% |
| CU BENEFITS ALLIANCE3 | PO BOX 12398 SALEM, OR 97309 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $351 | — | $351 | 9.98% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CONTRACT ADMINISTRATOR | Other services; Float revenue; Contract Administrator; Named fiduciary; Non-monetary compensation; Claims processing; Participant communication; Direct payment from the plan Service code 12 | — | $157K |
| CU BENEFITS EIN 61-1691027 BROKER | Insurance agents and brokers Service code 22 | — | $69K |
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 | 231 | 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) | 231 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF OREGON | 200 | $202K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 353 | $30K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 246 | $35K |
| Other(2 contracts, 2 carriers) | CASCADE CENTERS INC | 353 | $10K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 353 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.