| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFIT DESIGN GROUP INC3 Filed as: BENEFIT DESIGN GROUP LLC | 7140 SOUTHWEST FIR LOOP SUITE 220 PORTLAND, OR 97223 | PROVIDENCE HEALTH PLAN | $34K | — | $34K | 2.83% |
| BENEFIT DESIGN GROUP INC3 Filed as: BENEFIT DESIGN GROUP, LLC | 7140 SOUTHWEST FIR LOOP SUITE 220 PORTLAND, OR 97223 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $21K | $336 | $22K | 2.95% |
| BENEFIT DESIGN GROUP INC3 Filed as: BENEFIT DESIGN GROUP LLC | 7140 SOUTHWEST FIR LOOP SUITE 220 PORTLAND, OR 97223 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $16K | — | $16K | 10.00% |
| BENEFIT DESIGN GROUP INC3 Filed as: BENEFIT DESIGN GROUP LLC | 7140 SOUTHWEST FIR LOOP SUITE 220 PORTLAND, OR 97223 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $11K | — | $11K | 15.00% |
| BENEFIT DESIGN GROUP INC3 Filed as: BENEFIT DESIGN GROUP LLC | 7140 SOUTHWEST FIR LOOP SUITE 220 PORTLAND, OR 97223 | THE LINCOLN LIFE INSURANCE COMPANY | $3K | — | $3K | 5.76% |
| BENEFIT DESIGN GROUP INC3 Filed as: BENEFIT DESIGN GROUP | 7140 SOUTHWEST FIR LOOP SUITE 220 PORTLAND, OR 97223 | METROPOLITAN LIFE INSURANCE COMPANY | $7K | — | $7K | 23.92% |
| BENEFIT DESIGN GROUP INC3 Filed as: BENEFIT DESIGN GROUP | 7140 SOUTHWEST FIR LOOP SUITE 220 PORTLAND, OR 97223 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 6.20% |
| CARR INSURANCE AGENCY LLC3 Filed as: CARR INSURANCE AGENCY, LLC | P.O. BOX 4545 BEAVERTON, OR 97076 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 4.29% |
| INFINITI BENEFITS LLC3 | 21144 DARNEL AVENUE BEND, OR 97702 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $405 | — | $405 | 1.54% |
| SUPPLEMENTAL BENEFIT SOLUTIONS3 | PO BOX 1849 LAKE OSWEGO, OR 97035 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $174 | — | $174 | 0.66% |
| CHARLOTTE R SANTA CRUZ3 | 718 DUNBAR AVENUE SUITE 3A BAY ST LOUIS, MS 39520 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $170 | — | $170 | 0.65% |
| BENEFIT DESIGN GROUP INC3 Filed as: BENEFIT DESIGN GROUP | 7140 SOUTHWEST FIR LOOP SUITE 220 PORTLAND, OR 97223 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $942 | — | $942 | 5.50% |
| CARR INSURANCE AGENCY LLC3 Filed as: CARR INSURANCE AGENCY, LLC | PO BOX 4545 BEAVERTON, OR 97076 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $656 | — | $656 | 3.83% |
| INFINITI BENEFITS LLC3 | 21144 DARNEL AVE BEND, OR 97702 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $252 | — | $252 | 1.47% |
| SUPPLEMENTAL BENEFIT SOLUTIONS3 | PO BOX 1849 LAKE OSWEGO, OR 97035 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $107 | — | $107 | 0.62% |
| CHARLOTTE R SANTA CRUZ3 | 718 DUNBAR AVENUE SUITE 3A BAY ST LOUIS, MS 39520 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $99 | — | $99 | 0.58% |
| BENEFIT DESIGN GROUP INC3 Filed as: BENEFIT DESIGN GROUP | 7140 SOUTHWEST FIR LOOP SUITE 220 PORTLAND, OR 97223 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $675 | — | $675 | 4.47% |
| CARR INSURANCE AGENCY LLC3 Filed as: CARR INSURANCE AGENCY, LLC | PO BOX 4545 BEAVERTON, OR 97076 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $421 | — | $421 | 2.79% |
| SUPPLEMENTAL BENEFIT SOLUTIONS3 | PO BOX 1849 LAKE OSWEGO, OR 97035 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $78 | — | $78 | 0.52% |
| CHARLOTTE R SANTA CRUZ3 | 718 DUNBAR AVENUE SUITE 3A BAY ST LOUIS, MS 39520 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $29 | — | $29 | 0.19% |
| BENEFIT DESIGN GROUP INC3 Filed as: BENEFIT DESIGN GROUP LLC | 7140 SOUTHWEST FIR LOOP SUITE 220 PORTLAND, OR 97223 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| BENEFIT DESIGN GROUP INC3 Filed as: BENEFIT DESIGN GROUP | 7140 SOUTHWEST FIR LOOP SUITE 220 PORTLAND, OR 97223 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $463 | — | $463 | 6.86% |
| CARR INSURANCE AGENCY LLC3 Filed as: CARR INSURANCE AGENCY, LLC | P O BOX 4545 BEAVERTON, OR 97076 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $326 | — | $326 | 4.83% |
| INFINITI BENEFITS LLC3 | 21144 DARNEL AVENUE BEND, OR 97702 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $83 | — | $83 | 1.23% |
| CHARLOTTE R SANTA CRUZ3 | 718 DUNBAR AVENUE SUITE 3A BAY ST LOUIS, MS 39520 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $63 | — | $63 | 0.93% |
| SUPPLEMENTAL BENEFIT SOLUTIONS3 | PO BOX 1849 LAKE OSWEGO, OR 97035 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $50 | — | $50 | 0.74% |
| BENEFIT DESIGN GROUP INC3 Filed as: BENEFIT DESIGN GROUP | 7140 SOUTHWEST FIR LOOP SUITE 220 PORTLAND, OR 97223 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $325 | — | $325 | 8.42% |
| CARR INSURANCE AGENCY LLC3 Filed as: CARR INSURANCE AGENCY, LLC | PO BOX 4545 BEAVERTON, OR 97076 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $233 | — | $233 | 6.04% |
| CHARLOTTE R SANTA CRUZ3 | 718 DUNBAR AVENUE SUITE 3A BAY ST LOUIS, MS 39520 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $56 | — | $56 | 1.45% |
| INFINITI BENEFITS LLC3 | 21144 DARNEL AVENUE BEND, OR 97702 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $41 | — | $41 | 1.06% |
| SUPPLEMENTAL BENEFIT SOLUTIONS3 | PO BOX 1849 LAKE OSWEGO, OR 97035 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $30 | — | $30 | 0.78% |
| BENEFIT DESIGN GROUP INC3 Filed as: BENEFIT DESIGN GROUP | 7140 SOUTHWEST FIR LOOP SUITE 220 PORTLAND, OR 97223 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $188 | — | $188 | 6.83% |
| CARR INSURANCE AGENCY LLC3 Filed as: CARR INSURANCE AGENCY, LLC | PO BOX 4545 BEAVERTON, OR 97076 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $112 | — | $112 | 4.07% |
| INFINITI BENEFITS LLC3 | 21144 DARNEL AVENUE BEND, OR 97702 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $32 | — | $32 | 1.16% |
| CHARLOTTE R SANTA CRUZ3 | 718 DUNBAR AVENUE SUITE 3A BAY ST LOUIS, MS 39520 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $29 | — | $29 | 1.05% |
| SUPPLEMENTAL BENEFIT SOLUTIONS3 | PO BOX 1849 LAKE OSWEGO, OR 97035 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $18 | — | $18 | 0.65% |
| BENEFIT DESIGN GROUP INC3 Filed as: BENEFIT DESIGN GROUP | 7140 SOUTHWEST FIR LOOP SUITE 220 PORTLAND, OR 97223 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $83 | — | $83 | 5.10% |
| CARR INSURANCE AGENCY LLC3 Filed as: CARR INSURANCE AGENCY, LLC | PO BOX 4545 BEAVERTON, OR 97076 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $66 | — | $66 | 4.06% |
| SUPPLEMENTAL BENEFIT SOLUTIONS3 | PO BOX 1849 LAKE OSWEGO, OR 97035 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $11 | — | $11 | 0.68% |
| CHARLOTTE R SANTA CRUZ3 | 718 DUNBAR AVENUE SUITE 3A BAY ST LOUIS, MS 39520 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $11 | — | $11 | 0.68% |
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 | 425 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 427 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(9 contracts, 3 carriers) | PROVIDENCE HEALTH PLAN | 177 | $2.0M |
| Dental(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 391 | $191K |
| Vision | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 80 | $10K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 391 | $29K |
| Short-term disability | THE LINCOLN LIFE INSURANCE COMPANY | 127 | $51K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 127 | $71K |
| Prescription drug(2 contracts, 2 carriers) | PROVIDENCE HEALTH PLAN | 177 | $1.9M |
| Other(7 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 391 | $100K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 391 | — |
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."
No prospect flags tripped on this filing.