| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PCF INSURANCE SERVICES OF THE WEST3 | 412 JEFFERSON PARKWAY STE #203 LAKE OSWEGO, OR 97035 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $117K | $115 | $117K | 1.92% |
| MONTGOMERY & GRAHAM INC3 Filed as: MONTGOMERY & GRAHAM, INC. (SALEM) | 625 HAWTHORNE AVE. SE #100 SALEM, OR 97301 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $11K | — | $11K | 0.19% |
| PCF INSURANCE SERVICES OF THE WEST3 Filed as: PCF INSURANCE SERVICES | 412 JEFFERSON PARKWAY SUITE 203 OSWEGO, OR 97035 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $26K | — | $26K | 5.91% |
| PCF INSURANCE SERVICES OF THE WEST3 | 105 MONTGOMERY AVE MONTOGERYVILLE, PA 18936 | STANDARD INSURANCE COMPANY | $9K | — | $9K | 5.00% |
| MONTGOMERY & GRAHAM INC3 Filed as: MONTGOMERY & GRAHAM | 412 JEFFERSON PARKWAY 203 LAKE OSWEGO, OR 97035 | ACE AMERICAN INSURANCE COMPANY | $892 | — | $892 | 15.00% |
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 | 806 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 806 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 806 | $6.1M |
| Dental | STANDARD INSURANCE COMPANY | 258 | $186K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 584 | $432K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 584 | $432K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 584 | $432K |
| Other(3 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 584 | $453K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 806 | — |
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.