| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTERMEDIARY SERVICES LLC3 Filed as: INTERMEDIARY SERVICES | 333 S STATE ST STE V283 LAKE OSWEGO, OR 970343948 | METRPOLITAN LIFE INSURANCE COMPANY | $2K | $886 | $3K | 8.07% |
| INTERMEDIARY SERVICES LLC3 Filed as: INTERMEDIARY SERVICES, LLC | 333 S STATE ST SUITE V 283 LAKE OSWEGO, OR 97034 | SUN LIFE ASSURANCE COMPANY OF CANADA | $1K | — | $1K | 11.57% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTHCOMP ADMINISTRATORS EIN 77-0385729 CONTRACT ADMIN | Contract Administrator; Direct payment from the plan; Claims processing Service code 12 | — | $12K |
| CIGNA EIN 59-1031071 PPO/UR VENDOR | Direct payment from the plan; Other fees Service code 50 | — | $7K |
| INTERMEDIARY SERVICES EIN 93-1323288 BROKER | Insurance agents and brokers; Direct payment from the plan Service code 22 | — | $4K |
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 | 36 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 37 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METRPOLITAN LIFE INSURANCE COMPANY | 0 | $38K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 34 | $10K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 34 | $10K |
| Stop-loss / reinsurancereinsurance | QBE INSURANCE | 0 | $56K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 34 | $10K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 34 | — |
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."
No prospect flags tripped on this filing.