| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LEET, BRIAN3 | 9677 SW 74TH AVE TIGARD, OR 97223 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | $0 | $5K | 7.68% |
| INTERMEDIARY SERVICES LLC3 | 3760 MARKET ST NE SALEM, OR 97301 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $0 | $1K | 1.91% |
| SAMSON, LINET3 | 61540 COLDSTREAM RD COOS BAY, OR 97420 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $289 | $0 | $289 | 0.41% |
| LEET, BRIAN3 | 9677 SW 7TH AVE TIGARD, OR 97223 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | $0 | $5K | 7.72% |
| INTERMEDIARY SERVICES LLC3 | 3760 MARKET ST NE SUITE 452 SALEM, OR 97301 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $0 | $1K | 1.88% |
| SAMSON, LINET3 | 61540 COLDSTREAM RD COOS BAY, OR 97420 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $242 | $0 | $242 | 0.40% |
| LEET, BRIAN3 | 9677 SW 74TH AVE TIGARD, OR 97223 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $600 | $0 | $600 | 7.70% |
| INTERMEDIARY SERVICES LLC3 | 3760 MARKET ST NE SUITE 452 SALEM, OR 97301 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $147 | $0 | $147 | 1.89% |
| SAMSON, LINET3 | 61540 COLDSTREAM RD COOS BAY, OR 97420 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $31 | $0 | $31 | 0.40% |
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 | 255 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 267 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 332 | $184K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 363 | $71K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 287 | $131K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 363 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.