| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 1390 WILLOW PASS ROAD, SUITE 800 CONCORD, CA 94520 | REGENCE BLUECROSS BLUESHIELD OF OREGON | $63K | — | $63K | 3.00% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 1390 WILLOW PASS ROAD, SUITE 800 CONCORD, CA 94520 | STANDARD LIFE AND ACCIDENT INSURANCE COMPANY | $18K | — | $18K | 9.99% |
| MWL3 | P.O. BOX 14067 JACKSON, MS 39236 | STANDARD LIFE AND ACCIDENT INSURANCE COMPANY | $9K | $7K | $16K | 9.07% |
| POLESTAR BENEFITS INC3 Filed as: POLESTAR BENEFITS, INC. | 412 JEFFERSON PARKWAY, SUITE 202 LAKE OSWEGO, OR 97035 | STANDARD LIFE AND ACCIDENT INSURANCE COMPANY | $7K | — | $7K | 4.19% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 1390 WILLOW PASS ROAD, SUITE 800 CONCORD, CA 94520 | SUN LIFE ASSURANCE COMPANY OF CANADA | $16K | — | $16K | 8.82% |
| MGIS3 | 111 SOUTH MAIN STREET, SUITE 400 SALT LAKE CITY, UT 84111 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $180 | $180 | 0.10% |
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 | 220 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 222 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | REGENCE BLUECROSS BLUESHIELD OF OREGON | 217 | $2.3M |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 220 | $176K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 220 | $176K |
| Prescription drug | REGENCE BLUECROSS BLUESHIELD OF OREGON | 217 | $2.1M |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 220 | $176K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 220 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.