| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALDRICH BENEFITS LP3 | 5665 SW MEADOWS ROAD SUITE 200 LAKE OSWEGO, OR 970353131 | SUN LIFE ASSURANCE COMPANY OF CANADA | $12K | — | $12K | 2.57% |
| MGIS5 | 111 SOUTH MAIN STREET SUITE 400 SALT LAKE CITY, UT 841112176 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $180 | $180 | 0.04% |
| MAGNACORP INSURANCE AGENCY3 | 5665 MEADOWS RD, #350 LAKE OSWEGO, OR 97035 | THE PAUL REVERE LIFE INSURANCE COMPANY | $163 | — | $163 | 1.77% |
| TODD R STUCKY3 | 4821 SW WINDSOR CT PORTLAND, OR 97221 | THE PAUL REVERE LIFE INSURANCE COMPANY | $161 | — | $161 | 1.75% |
| STEPHEN KENNETH MELROSE3 | 9700 SW DUNCAN LN BEAVERTON, OR 97005 | THE PAUL REVERE LIFE INSURANCE COMPANY | $65 | — | $65 | 0.71% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMENCEMENT BAY EIN 91-1571623 NONE | Insurance services Service code 23 | — | $219K |
| HEALTHCARE MANAGEMENT ADMINISTRATOR EIN 91-1333840 NONE | Contract Administrator Service code 13 | — | $84K |
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 | 139 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 12 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 152 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMMENCEMENT BAY RISK MANAGEMENT INSURANCE COMPANY | 365 | $225K |
| Life insurance(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 252 | $466K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 252 | $457K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 252 | $457K |
| Stop-loss / reinsurancereinsurance | COMMENCEMENT BAY RISK MANAGEMENT INSURANCE COMPANY | 365 | $225K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 252 | $457K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 365 | — |
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.