| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LEONARD ADAMS INSURANCE INC3 | 5201 SW WESTGATE DR #300 PORTLAND, OR 97221 | AETNA LIFE INSURANCE COMPANY | — | $37K | $37K | 3.09% |
| LEONARD ADAMS INSURANCE INC3 | 5201 SW WESTGATE DR #300 PORTLAND, OR 97221 | AMERITAS LIFE INSURANCE CORP. | $2K | — | $2K | 4.58% |
| LEONARD ADAMS INSURANCE INC3 | 5201 SW WESTGATE DR #300 PORTLAND, OR 97221 | WILLAMETTE DENTAL INSURANCE, INC. | $2K | $4K | $6K | 15.00% |
| LEONARD ADAMS INSURANCE INC3 | 5201 SW WESTGATE DR #300 PORTLAND, OR 97221 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | $391 | $2K | 12.31% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANC COMPANY EIN 06-6033492 NONE | Named fiduciary; Direct payment from the plan; Participant communication; Other services; Float revenue; Contract Administrator; Non-monetary compensation; Claims processing Service code 12 | — | $37K |
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 | 217 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 217 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 246 | $1.2M |
| Dental(2 contracts, 2 carriers) | AMERITAS LIFE INSURANCE CORP. | 246 | $90K |
| Vision(2 contracts, 2 carriers) | AMERITAS LIFE INSURANCE CORP. | 246 | $68K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 246 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.