| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE HECHT GROUP3 | 425 NE HANCOCK PORTLAND, OR 97212 | WILLAMETTE DENTAL INSURANCE, INC. | $3K | — | $3K | 5.00% |
| HECHT & HECHT LIFE & HEALTH INS3 Filed as: HECHT & HECHT LIFE & HLTH | 425 NE HANCOCK PORTLAND, OR 97212 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | — | $4K | 9.80% |
| HECHT & HECHT LIFE & HEALTH INS3 Filed as: HECHT & HECHT LIFE & HLTH | 425 NE HANCOCK PORTLAND, OR 97212 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 7.17% |
| HECHT & HECHT LIFE & HEALTH INS3 Filed as: HECHT & HECHT LIFE & HLTH | 425 NE HANCOCK ST PORTLAND, OR 97212 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | — | $4K | 15.00% |
| HECHT & HECHT LIFE & HEALTH INS3 Filed as: HECHT & HECHT LIFE & HLTH | 425 NE HANCOCK PORTLAND, OR 97212 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 15.00% |
| HECHT & HECHT LIFE & HEALTH INS3 Filed as: HECHT & HECHT LIFE & HLTH | 425 NE HANCOCK PORTLAND, OR 97212 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $639 | — | $639 | 15.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPLOYEE BENEFIT MGMT SERVICES INC EIN 81-0391256 ADMIN FEES | Contract Administrator; Other fees Service code 13 | — | $145K |
| HECHT AND HECHT LIFE AND HEALTH EIN 20-2198349 BROKER | Insurance agents and brokers Service code 22 | — | $67K |
| ENVISION PHARM SERVICES EIN 05-0570786 RX FEES | Claims processing Service code 12 | — | $22K |
| FIRST CHOICE HEALTH EIN 91-1272766 PPO | Other services Service code 49 | — | $16K |
| CAREOPERATIVE LLC EIN 20-8981027 HEALTHCARE BLUEBOOK | Other fees Service code 99 | — | $8K |
| EMPLOYEE BENEFIT MGMT SERVICES LLC EIN 81-0391256 CASE MANAGEMENT | Other fees Service code 99 | — | $8K |
| MODA HEALTH EIN 93-0438772 DENTAL ADMIN FEES | Contract Administrator Service code 13 | — | $7K |
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 | 392 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 392 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | MODA HEALTH PLAN, INC. | 585 | $257K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 98 | $4K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 115 | $28K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 420 | $42K |
| Other(4 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 420 | $67K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 585 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.