| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LEONARD ADAMS INSURANCE INC3 | 5201 SW WESTGATE DR #300 PORTLAND, OR 97221 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $26K | — | $26K | 4.75% |
| LEONARD ADAMS INSURANCE INC3 | 5201 SW WESTGATE DR #300 PORTLAND, OR 97221 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $8K | — | $8K | 2.79% |
| LEONARD ADAMS INSURANCE INC | 5201 SW WESTGATE DR #300 PORTLAND, OR 97221 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $7K | — | $7K | 2.74% |
| LEONARD ADAMS INSURANCE INC3 | 5201 SW WESTGATE DR #300 PORTLAND, OR 97221 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $5K | — | $5K | 4.93% |
| LEONARD ADAMS INSURANCE INC3 | 5201 SW WESTGATE DR #300 PORTLAND, OR 97221 | WILLAMETTE DENTAL INSURANCE, INC. | $2K | — | $2K | 4.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 NONE | Direct payment from the plan; Float revenue; Other services; Contract Administrator; Participant communication; Named fiduciary; Non-monetary compensation; Claims processing Service code 12 | — | $5K |
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 | 293 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 293 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 153 | $1.1M |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 155 | $149K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 153 | $547K |
| Prescription drug(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 153 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 155 | — |
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.