| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFIT SPECIALISTS INC.3 | 5335 MEADOWS ROAD SUITE 255 LAKE OSWEGO, OR 97035 | REGENCE BLUECROSS BLUESHIELD OF OREGON | $16K | — | $16K | 1.48% |
| BENEFIT SPECIALISTS INC.3 | 5335 MEADOWS ROAD SUITE 255 LAKE OSWEGO, OR 97035 | MODA, INC. | $3K | — | $3K | 5.00% |
| BENEFIT SPECIALISTS INC.3 Filed as: BENEFIT SPECIALISTS, INC. | 5335 MEADOWS ROAD SUITE 255 LAKE OSWEGO, OR 97035 | WILLAMETTE DENTAL INSURANCE, INC. | $935 | — | $935 | 5.00% |
| BENEFIT SPECIALISTS INC.3 | 5335 MEADOWS ROAD SUITE 255 LAKE OSWEGO, OR 970353113 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 20.00% |
| BENEFIT SPECIALISTS INC.3 | 5335 MEADOWS ROAD SUITE 255 LAKE OSWEGO, OR 970353113 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 20.00% |
| BENEFIT SPECIALISTS INC.3 | 5335 MEADOWS ROAD SUITE 255 LAKE OSWEGO, OR 970353113 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 20.00% |
| BENEFIT SPECIALISTS INC.3 | 5335 MEADOWS ROAD SUITE 255 LAKE OSWEGO, OR 97035 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $775 | — | $775 | 10.24% |
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 | 117 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 118 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | REGENCE BLUECROSS BLUESHIELD OF OREGON | 219 | $1.1M |
| Dental(2 contracts, 2 carriers) | MODA, INC. | 147 | $86K |
| Vision(2 contracts, 2 carriers) | REGENCE BLUECROSS BLUESHIELD OF OREGON | 219 | $1.1M |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 42 | $18K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 32 | $10K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 26 | $18K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 42 | $18K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 219 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.