| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTERMEDIARY SERVICES LLC3 Filed as: INTERMEDIARY SERVICES | 333 S STATE ST STE V283 LAKE OSWEGO, OR 97034 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | $0 | $8K | 15.25% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPLOYEE BENEFIT MGMT SERVICES LLC EIN 81-0391256 TPA | Contract Administrator Service code 13 | — | $54K |
| INTERMEDIARY SERVICES LLC EIN 93-1323288 BROKER | Insurance agents and brokers Service code 22 | — | $40K |
| AETNA SIGNATURE ADMINISTRATORS EIN 06-6033492 PPO | Other services Service code 49 | — | $26K |
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 | 144 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 145 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 214 | $50K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 214 | $50K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 381 | $537K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 214 | $50K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 381 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.