| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFIT DESIGN GROUP INC3 Filed as: BENEFIT DESIGN GROUP, LLC | 7140 SW FIR LOOP 220 PORTLAND, OR 97223 | PROVIDENCE HEALTH PLAN | $19K | — | $19K | 2.13% |
| BENEFIT DESIGN GROUP INC3 Filed as: BENEFIT DESIGN GROUP, LLC | 7140 SW FIR LOOP 220 PORTLAND, OR 97223 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $14K | $510 | $14K | 2.06% |
| BENEFIT DESIGN GROUP INC3 Filed as: BENEFIT DESIGN GROUP, LLC | 7140 SW FIR LOOP 220 PORTLAND, OR 97223 | METROPOLITAN LIFE INSURANCE COMPANY | $19K | — | $19K | 11.81% |
| BENEFIT DESIGN GROUP INC3 Filed as: BENEFIT DESIGN GROUP, LLC | 7140 SW FIR LOOP 220 PORTLAND, OR 97223 | AMERICAN HERITAGE LIFE INSURANCE | $5K | — | $5K | 21.40% |
| CARR INSURANCE AGENCY LLC3 | PO BOX 4545 BEAVERTON, OR 97076 | AMERICAN HERITAGE LIFE INSURANCE | $4K | — | $4K | 17.12% |
| CHARLOTTE R SANTA CRUZ4 | 718 DUNBAR AVENUE SUITE 3A BAY ST LOUIS, MO 39520 | AMERICAN HERITAGE LIFE INSURANCE | $1K | — | $1K | 4.87% |
| SUPPLEMENTAL BENEFIT SOLUTIONS4 | PO BOX 1849 LAKE OSWEGO, OR 97035 | AMERICAN HERITAGE LIFE INSURANCE | $329 | — | $329 | 1.50% |
| CARR INSURANCE AGENCY LLC3 | PO BOX 4545 BEAVERTON, OR 97076 | AMERICAN HERITAGE LIFE INSURANCE | $2K | — | $2K | 14.03% |
| BENEFIT DESIGN GROUP INC3 Filed as: BENEFIT DESIGN GROUP, LLC | 7140 SW FIR LOOP 220 PORTLAND, OR 97223 | AMERICAN HERITAGE LIFE INSURANCE | $815 | — | $815 | 5.08% |
| CHARLOTTE R SANTA CRUZ4 | 718 DUNBAR AVENUE SUITE 3A BAY ST LOUIS, MO 39520 | AMERICAN HERITAGE LIFE INSURANCE | $297 | — | $297 | 1.85% |
| SUPPLEMENTAL BENEFIT SOLUTIONS4 | PO BOX 1849 LAKE OSWEGO, OR 97035 | AMERICAN HERITAGE LIFE INSURANCE | $88 | — | $88 | 0.55% |
| BENEFIT DESIGN GROUP INC3 Filed as: BENEFIT DESIGN GROUP, LLC | 7140 SW FIR LOOP 220 PORTLAND, OR 97223 | AMERICAN HERITAGE LIFE INSURANCE | $4K | — | $4K | 23.64% |
| CARR INSURANCE AGENCY LLC3 | PO BOX 4545 BEAVERTON, OR 97076 | AMERICAN HERITAGE LIFE INSURANCE | $3K | — | $3K | 18.91% |
| CHARLOTTE R SANTA CRUZ4 | 718 DUNBAR AVENUE SUITE 3A BAY ST LOUIS, MO 39520 | AMERICAN HERITAGE LIFE INSURANCE | $824 | — | $824 | 5.32% |
| SUPPLEMENTAL BENEFIT SOLUTIONS4 | PO BOX 1849 LAKE OSWEGO, OR 97035 | AMERICAN HERITAGE LIFE INSURANCE | $233 | — | $233 | 1.50% |
| BENEFIT DESIGN GROUP INC3 Filed as: BENEFIT DESIGN GROUP, LLC | 7140 SW FIR LOOP 220 PORTLAND, OR 97223 | AMERICAN HERITAGE LIFE INSURANCE | $2K | — | $2K | 24.65% |
| CARR INSURANCE AGENCY LLC3 | PO BOX 4545 BEAVERTON, OR 97076 | AMERICAN HERITAGE LIFE INSURANCE | $1K | — | $1K | 19.71% |
| CHARLOTTE R SANTA CRUZ4 | 718 DUNBAR AVENUE SUITE 3A BAY ST LOUIS, MO 39520 | AMERICAN HERITAGE LIFE INSURANCE | $368 | — | $368 | 5.65% |
| SUPPLEMENTAL BENEFIT SOLUTIONS4 | PO BOX 1849 LAKE OSWEGO, OR 97035 | AMERICAN HERITAGE LIFE INSURANCE | $107 | — | $107 | 1.64% |
| BENEFIT DESIGN GROUP INC3 Filed as: BENEFIT DESIGN GROUP, LLC | 7140 SW FIR LOOP 220 PORTLAND, OR 97223 | GUARDIAN LIFE INSURANCE CO OF AMERICA | $597 | — | $597 | 10.01% |
| WEALTH STRATEGIES NORTHWEST4 Filed as: WEALTH STRATGAGIES NW, LLC | 5100 SW MACADAM PORTLAND, OR 97239 | GUARDIAN LIFE INSURANCE CO OF AMERICA | $12 | — | $12 | 0.20% |
| BENEFIT DESIGN GROUP INC3 Filed as: BENEFIT DESIGN GROUP, LLC | 7140 SW FIR LOOP 220 PORTLAND, OR 97223 | AMERICAN HERITAGE LIFE INSURANCE | $956 | — | $956 | 19.20% |
| CARR INSURANCE AGENCY LLC3 | PO BOX 4545 BEAVERTON, OR 97076 | AMERICAN HERITAGE LIFE INSURANCE | $765 | — | $765 | 15.36% |
| CHARLOTTE R SANTA CRUZ4 | 718 DUNBAR AVENUE SUITE 3A BAY ST LOUIS, MO 39520 | AMERICAN HERITAGE LIFE INSURANCE | $216 | — | $216 | 4.34% |
| SUPPLEMENTAL BENEFIT SOLUTIONS4 | PO BOX 1849 LAKE OSWEGO, OR 97035 | AMERICAN HERITAGE LIFE INSURANCE | $71 | — | $71 | 1.43% |
| BENEFIT DESIGN GROUP INC3 Filed as: BENEFIT DESIGN GROUP, LLC | 7140 SW FIR LOOP 220 PORTLAND, OR 97076 | AMERICAN HERITAGE LIFE INSURANCE | $934 | — | $934 | 25.02% |
| CARR INSURANCE AGENCY LLC3 | PO BOX 4545 BEAVERTON, OR 97076 | AMERICAN HERITAGE LIFE INSURANCE | $747 | — | $747 | 20.01% |
| CHARLOTTE R SANTA CRUZ4 | 718 DUNBAR AVENUE SUITE 3A BAY ST LOUIS, MO 39520 | AMERICAN HERITAGE LIFE INSURANCE | $210 | — | $210 | 5.63% |
| SUPPLEMENTAL BENEFIT SOLUTIONS4 | PO BOX 1849 LAKE OSWEGO, OR 97035 | AMERICAN HERITAGE LIFE INSURANCE | $59 | — | $59 | 1.58% |
| BENEFIT DESIGN GROUP INC3 Filed as: BENEFIT DESIGN GROUP, LLC | 7140 SW FIR LOOP 220 PORTLAND, OR 97223 | AMERICAN HERITAGE LIFE INSURANCE | $324 | — | $324 | 19.93% |
| CARR INSURANCE AGENCY LLC3 | PO BOX 4545 BEAVERTON, OR 97076 | AMERICAN HERITAGE LIFE INSURANCE | $259 | — | $259 | 15.93% |
| CHARLOTTE R SANTA CRUZ4 | 718 DUNBAR AVENUE SUITE 3A BAY ST LOUIS, MO 39520 | AMERICAN HERITAGE LIFE INSURANCE | $72 | — | $72 | 4.43% |
| SUPPLEMENTAL BENEFIT SOLUTIONS4 | PO BOX 1849 LAKE OSWEGO, OR 97035 | AMERICAN HERITAGE LIFE INSURANCE | $25 | — | $25 | 1.54% |
| PREMIER WORKSIDE SOLUTIONS INC4 | 806 NW 79TH STREET VANCOUVER, WA 98665 | COLONIAL LIFE & ACCIDENT INSURANCE | $6 | — | $6 | 0.88% |
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 | 185 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 185 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(9 contracts, 3 carriers) | PROVIDENCE HEALTH PLAN | 189 | $1.6M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 541 | $159K |
| Vision | GUARDIAN LIFE INSURANCE CO OF AMERICA | 26 | $6K |
| Life insurance(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 541 | $176K |
| Prescription drug(2 contracts, 2 carriers) | PROVIDENCE HEALTH PLAN | 189 | $1.6M |
| Other(7 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 541 | $227K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 541 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.