| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | UNKNOWN WILSONVILLE, OR 97070 | WILLAMETTE DENTAL INSURANCE, INC. | $3K | $0 | $3K | 9.97% |
| CRYSTAL ANN MCCARTHY3 | 2715 SW 31ST STREET GRESHAM, OR 97080 | AFLAC | $3K | $144 | $3K | 9.21% |
| PACIFIC BENEFIT SOLUTIONS LLC3 | PO BOX 5734 KENT, WA 98064 | AFLAC | $1K | $3 | $1K | 3.98% |
| RYAN SMITH AND OTHER AGENTS3 | 5900 SW ADMIRAL WAY, APT 1B SEATTLE, WA 98116 | AFLAC | $1K | $0 | $1K | 3.32% |
| ANGEL X ESCAMILLA3 Filed as: ANGEL X. ESCAMILLA | 4920 SW LOMBARD AVENUE BEAVERTON, OR 97005 | AFLAC | $888 | $70 | $958 | 3.05% |
| WILLIAM JAMES MCPHEE3 | 20332 SW ERIN PLACE ALOHA, OR 97003 | AFLAC | $554 | $0 | $554 | 1.77% |
| JAMES S SARANTIS3 Filed as: JAMES S. SARANTIS | 14132 SE FIRCREST COURT PORTLAND, OR 97236 | AFLAC | $468 | $42 | $510 | 1.63% |
| BONNIE LOUESE MCCREERY3 | 524 LAUREL STREET LAKE OSWEGO, OR 97034 | AFLAC | $282 | $0 | $282 | 0.90% |
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 | 45 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 45 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | WILLAMETTE DENTAL INSURANCE, INC. | 68 | $31K |
| Vision | AFLAC | 47 | $31K |
| Life insurance | AFLAC | 47 | $31K |
| Short-term disability | AFLAC | 47 | $31K |
| Other | AFLAC | 47 | $31K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 68 | — |
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.