| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SCOTT LYDA3 | 976 HENNING WAY N SALEM, OR 97303 | ALL SAVERS INSURANCE COMPANY | $23K | — | $23K | 8.04% |
| MONTGOMERY & GRAHAM INC3 Filed as: MONTGOMERY & GRAHAM CONSULTING | — | OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON | $3K | — | $3K | 4.01% |
| MONTGOMERY & GRAHAM INC3 Filed as: MONTGOMERY & GRAHAM CONSULTING | — | OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON | $328 | — | $328 | 4.01% |
| MONTGOMERY & GRAHAM INC3 Filed as: MONTGOMERY & GRAHAM, INC. | 412 JEFFERSON PKWY STE 100 LAKE OSWEGO, OR 97035 | VISION SERVICE PLAN | $661 | — | $661 | 8.13% |
| MONTGOMERY & GRAHAM INC3 | 412 JEFFERSON PKWY STE 100 LAKE OSWEGO, OR 97035 | AFLAC | $771 | — | $771 | 17.48% |
| ANDREW N LUCCOCK3 | 19766 WILDWOOD DR WEST LINN, OR 97068 | AFLAC | $152 | — | $152 | 3.45% |
| BRIDGET RENEA TOWNSEND3 | 28317 SW PARIS AVE WILSONVILLE, OR 97070 | AFLAC | $17 | — | $17 | 0.39% |
| ANDREW N LUCCOCK3 | PO BOX 1965 WILSONVILLE, OR 97070 | AFLAC | $16 | — | $16 | 0.36% |
| TERRY ANN PARKER3 | 11175 SW BERLIN AVE WILSONVILLE, OR 97070 | AFLAC | $16 | — | $16 | 0.36% |
| G SCOTT COOKE3 Filed as: SCOTT E NIELSEN | 718B W FOURTH PLAIN BLVD VANCOUVER, WA 98660 | AFLAC | $12 | — | $12 | 0.27% |
| BRIAN L HUGGER3 | 10117 SE SUNNYSIDE RD STE F52 CLACKAMAS, OR 97015 | AFLAC | $7 | — | $7 | 0.16% |
| IOANNIS T GRATSINOPOULOS3 | 1893 E DAULBY ST MERIDIAN, IA 83642 | AFLAC | $3 | — | $3 | 0.07% |
| CAMERON CARRILLO3 | 61503 ORION DR BEND, OR 97702 | AFLAC | $2 | — | $2 | 0.05% |
| MATTHEW G BERGER3 Filed as: MATTHEW SHROYER | 1384 NE 70TH AVE PORTLAND, OR 97213 | AFLAC | $2 | — | $2 | 0.05% |
| ERIC DANIEL WEILAND3 | 14511 SW CORNERSTONE LN SHERWOOD, OR 97140 | AFLAC | $2 | — | $2 | 0.05% |
| MICHAEL C WALKER3 Filed as: MICHAEL M STASTNY | 605 PORTLAND AVE UNIT 531 GLADSTONE, OR 97027 | AFLAC | $1 | — | $1 | 0.02% |
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 | 100 | 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) | 100 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(3 contracts, 2 carriers) | OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON | 153 | $78K |
| Vision | VISION SERVICE PLAN | 62 | $8K |
| Life insurance | AMERICAN INSTITUTE OF CERTIFIED PUBLIC ACCOUNTANTS GROUP INSURANCE TRU | 97 | $16K |
| Short-term disability(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 94 | $21K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 111 | $22K |
| Stop-loss / reinsurancereinsurance | ALL SAVERS INSURANCE COMPANY | 100 | $290K |
| Other | AFLAC | 7 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 153 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.