| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WELLS FARGO INSURANCE SERVICES3 | PO BOX 203588 DALLAS, TX 73320 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $2K | $2K | 2.75% |
| JEROMY E. CILLEY3 Filed as: JEROMY E CILLEY | 116 HIGHWAY 99 N STE 112 EUGENE, OR 97402 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 4.25% |
| MJ INSURANCE3 Filed as: AND VARIOUS AGENTS | — | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 4.18% |
| WELLS FARGO INSURANCE SERVICES3 | 601 UNION ST STE 1300 SEATTLE, WA 98101 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 3.60% |
| ARMFIELD HARRISON & THOMAS3 Filed as: ARMFIELD HARRISON & THOMAS INC | 20 SOUTH KING STREET LEESBURG, VA 20175 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 3.53% |
| VERENA NORTH3 | 2636 NW 26TH AVE 201 PORTLAND, OR 97217 | CONTINENTAL AMERICAN INSURANCE COMPANY | $971 | — | $971 | 2.86% |
| WANDA K VINING ALBER3 | 110 9TH ST SW JAMESTOWN, ND 58401 | CONTINENTAL AMERICAN INSURANCE COMPANY | $634 | — | $634 | 1.86% |
| PAUL J LANGAS3 | 13314 SE 19TH STREET APT R2 VANCOUVER, WA 98683 | CONTINENTAL AMERICAN INSURANCE COMPANY | $230 | — | $230 | 0.68% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICE | PO BOX 203588 DALLAS, TX 73320 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $551 | $551 | 2.24% |
| WELLS FARGO INSURANCE SERVICES3 | PO BOX 203588 DALLAS, TX 73320 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $135 | $135 | 2.32% |
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 | 234 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 238 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 234 | $56K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 234 | $25K |
| Other(2 contracts, 2 carriers) | CONTINENTAL AMERICAN INSURANCE COMPANY | 234 | $40K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 234 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.