| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CU BENEFITS ALLIANCE3 | 451 DIVISION ST NE SALEM, OR 97301 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 5.53% |
| CU BENEFITS ALLIANCE3 | 451 DIVISION ST NE SALEM, OR 97301 | WILLAMETTE DENTAL INSURANCE INC | $5K | $10K | $14K | 15.00% |
| CU BENEFITS ALLIANCE3 | 451 DIVISION ST NE SALEM, OR 97301 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $11K | — | $11K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BERKLEY LIFE & HEALTH EIN 91-6034263 INSURANCE | Insurance services Service code 23 | — | $434K |
| HEALTHCARE MANAGEMENT ADMINISTRATOR EIN 91-1333840 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $201K |
| CU BENEFITS ALLIANCE EIN 61-1691027 BROKER | Insurance agents and brokers Service code 22 | — | $104K |
| PACIFICSOURCE HEALTH PLANS EIN 93-0245545 INSURER | Insurance services Service code 23 | — | $25K |
| NAVIA BENEFITS EIN 91-1467758 CONTRARCT ADMINISTRATOR | Contract Administrator Service code 13 | — | $13K |
| UNUM LIFE INSURANCE CO OF AMERICA EIN 01-0278678 NONE | Insurance services Service code 23 | — | $12K |
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 | 510 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 14 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 533 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CASCADE HEALTH | 521 | $12K |
| Dental | WILLAMETTE DENTAL INSURANCE INC | 163 | $96K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 551 | $228K |
| Short-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 551 | $228K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 551 | $153K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 551 | — |
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.