| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFIT DESIGN GROUP INC3 Filed as: BENEFIT DESIGN GROUP LLC | 7140 SW FIR LOOP STE 220 PORTLAND, OR 97223 | PROVIDENCE HEALTH PLAN | $31K | — | $31K | 2.74% |
| 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 | $21K | $635 | $22K | 3.10% |
| BENEFIT DESIGN GROUP INC3 Filed as: BENEFIT DESIGN GROUP LLC | 7140 SW FIR LOOP STE 220 PORTLAND, OR 97223 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $14K | — | $14K | 10.00% |
| BENEFIT DESIGN GROUP INC3 Filed as: BENEFIT DESIGN GROUP LLC | 7140 SW FIR LOOP STE 220 PORTLAND, OR 97223 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $12K | — | $12K | 15.00% |
| BENEFIT DESIGN GROUP INC3 Filed as: BENEFIT DESIGN GROUP LLC | 7140 SW FIR LOOP STE 220 PORTLAND, OR 97223 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 5.95% |
| BENEFIT DESIGN GROUP INC3 Filed as: BENEFIT DESIGN GROUP | 7140 SW FIR LOOP STE 220 PORTLAND, OR 97223 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | — | $4K | 13.14% |
| BENEFIT DESIGN GROUP INC3 Filed as: BENEFIT DESIGN GROUP | 7140 SW FIR LOOP STE 220 PORTLAND, OR 97223 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 8.25% |
| BRYAN BULLOCK3 | 384 Q STREET SPRINGFIELD, OR 97477 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $881 | — | $881 | 5.18% |
| INFINITI BENEFITS LLC3 | 21144 DARNEL AVE BEND, OR 97702 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $700 | — | $700 | 4.11% |
| SUPPLEMENTAL BENEFIT SOLUTIONS3 | PO BOX 1849 LAKE OSWEGO, OR 97035 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $155 | — | $155 | 0.91% |
| CHARLOTTE R SANTA CRUZ3 | 718 DUNBAR AVENUE SUITE 3A BAY ST LOUIS, MS 39520 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $85 | — | $85 | 0.50% |
| BENEFIT DESIGN GROUP INC3 Filed as: BENEFIT DESIGN GROUP | 7140 SW FIR LOOP STE 220 PORTLAND, OR 97223 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $529 | — | $529 | 4.55% |
| BRYAN BULLOCK3 | 384 Q STREET SPRINGFIELD, OR 97477 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $324 | — | $324 | 2.79% |
| SUPPLEMENTAL BENEFIT SOLUTIONS3 | PO BOX 1849 LAKE OSWEGO, OR 97035 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $60 | — | $60 | 0.52% |
| CHARLOTTE R SANTA CRUZ3 | 718 DUNBAR AVENUE SUITE 3A BAY ST LOUIS, MS 39520 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $23 | — | $23 | 0.20% |
| BENEFIT DESIGN GROUP INC3 Filed as: BENEFIT DESIGN GROUP | 7140 SW FIR LOOP STE 220 PORTLAND, OR 97223 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $820 | — | $820 | 7.23% |
| BRYAN BULLOCK3 | 384 Q STREET SPRINGFIELD, OR 97477 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $502 | — | $502 | 4.43% |
| INFINITI BENEFITS LLC3 | 21144 DARNEL AVE BEND, OR 97702 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $390 | — | $390 | 3.44% |
| SUPPLEMENTAL BNFT SOLUTIONS3 | PO BOX 1849 LAKE OSWEGO, OR 97035 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $94 | — | $94 | 0.83% |
| CHARLOTTE R SANTA CRUZ3 | 718 DUNBAR AVENUE SUITE 3A BAY ST LOUIS, MS 39520 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $57 | — | $57 | 0.50% |
| BENEFIT DESIGN GROUP INC3 Filed as: BENEFIT DESIGN GROUP LLC | 7140 SW FIR LOOP STE 220 PORTLAND, OR 97223 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| BENEFIT DESIGN GROUP INC3 Filed as: BENEFIT DESIGN GROUP | 7140 SW FIR LOOP STE 220 PORTLAND, OR 97223 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $413 | — | $413 | 9.12% |
| BRYAN BULLOCK3 | 384 Q STREET SPRINGFIELD, OR 97477 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $235 | — | $235 | 5.19% |
| INFINITI BENEFITS LLC3 | 21144 DARNEL AVENUE BEND, OR 97702 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $210 | — | $210 | 4.64% |
| SUPPLEMENTAL BENEFIT SOLUTIONS3 | PO BOX 1849 LAKE OSWEGO, OR 97035 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $47 | — | $47 | 1.04% |
| CHARLOTTE R SANTA CRUZ3 | 718 DUNBAR AVE SUITE 3A BAY ST LOUIS, MS 39520 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $31 | — | $31 | 0.68% |
| BENEFIT DESIGN GROUP INC3 Filed as: BENEFIT DESIGN GROUP | 7140 SW FIR LOOP STE 220 PORTLAND, OR 97223 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $173 | — | $173 | 8.49% |
| INFINITI BENEFITS LLC3 | 21144 DARNEL AVE BEND, OR 97702 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $101 | — | $101 | 4.96% |
| BRYAN BULLOCK3 | 384 Q STREET SPRINGFIELD, OR 97477 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $97 | — | $97 | 4.76% |
| SUPPLEMENTAL BENEFIT SOLUTIONS3 | PO BOX 1849 LAKE OSWEGO, OR 97035 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $19 | — | $19 | 0.93% |
| CHARLOTTE R SANTA CRUZ3 | 718 DUNBAR AVENUE SUITE 3A BAY ST LOUIS, MS 39520 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $11 | — | $11 | 0.54% |
| BENEFIT DESIGN GROUP INC3 Filed as: BENEFIT DESIGN GROUP | 7140 SW FIR LOOP STE 220 PORTLAND, OR 97223 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $123 | — | $123 | 6.40% |
| BRYAN BULLOCK3 | 384 Q STREET SPRINGFIELD, OR 97477 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $68 | — | $68 | 3.54% |
| INFINITI BENEFITS LLC3 | 21144 DARNEL AVENUE BEND, OR 97702 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $50 | — | $50 | 2.60% |
| SUPPLEMENTAL BENEFIT SOLUTIONS3 | PO BOX 1849 LAKE OSWEGO, OR 97035 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $17 | — | $17 | 0.88% |
| CHARLOTTE R SANTA CRUZ3 | 718 DUNBAR AVENUE SUITE 3A BAY ST LOUIS, MS 39520 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $11 | — | $11 | 0.57% |
| BENEFIT DESIGN GROUP INC3 Filed as: BENEFIT DESIGN GROUP | 7140 SW FIR LOOP STE 220 PORTLAND, OR 97223 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $85 | — | $85 | 8.56% |
| BRYAN BULLOCK3 | 384 Q STREET SPRINGFIELD, OR 97477 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $62 | — | $62 | 6.24% |
| INFINITI BENEFITS LLC3 | 21144 DARNEL AVE BEND, OR 97702 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $16 | — | $16 | 1.61% |
| SUPPLEMENTAL BENEFIT SOLUTIONS3 | PO BOX 1849 LAKE OSWEGO, OR 97035 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $11 | — | $11 | 1.11% |
| CHARLOTTE R SANTA CRUZ3 | 718 DUNBAR AVENUE SUITE 3A BAY ST LOUIS, MS 39520 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $9 | — | $9 | 0.91% |
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 | 414 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 416 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | PROVIDENCE HEALTH PLAN | 151 | $1.8M |
| Dental | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 177 | $143K |
| Vision | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 101 | $11K |
| Life insurance(5 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 384 | $64K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 346 | $48K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 130 | $82K |
| Prescription drug(2 contracts, 2 carriers) | PROVIDENCE HEALTH PLAN | 151 | $1.8M |
| Other(8 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 384 | $78K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 384 | — |
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.