| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CU BENEFITS ALLIANCE3 | 451 DIVISION ST NE SALEM, OR 97301 | WILLAMETTE DENTAL INSURANCE INC | $6K | — | $6K | 5.00% |
| CU BENEFITS ALLIANCE3 | 451 DIVISION ST NE SALEM, OR 97301 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $5K | — | $5K | 7.12% |
| CU BENEFITS ALLIANCE3 | 451 DIVISION ST NE SALEM, OR 97301 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $7K | — | $7K | 15.00% |
| CU BENEFITS ALLIANCE3 | 451 DIVISION ST NE SALEM, OR 97301 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 6.15% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BERKELEY LIFE & HEALTH EIN 91-6034263 NONE | Insurance services Service code 23 | — | $582K |
| HEALTHCARE MANAGEMENT ADMINISTRATOR EIN 91-1333840 NONE | Contract Administrator Service code 13 | — | $140K |
| CU BENEFITS ALLIANCE EIN 61-1691027 NONE | Insurance agents and brokers Service code 22 | — | $65K |
| SUN LIFE ASSURANCE CO OF CANADA EIN 38-1082080 NONE | Claims processing Service code 12 | — | $12K |
| ALLEGIANCE BENEFIT EIN 81-0400550 NONE | Contract Administrator Service code 13 | — | $6K |
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 | 308 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 311 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | WILLAMETTE DENTAL INSURANCE INC | 216 | $118K |
| Vision | VISION SERVICE PLAN | 260 | $36K |
| Life insurance(2 contracts) | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 327 | $94K |
| Long-term disability | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 308 | $67K |
| Other(3 contracts, 2 carriers) | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 330 | $104K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 330 | — |
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.