| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BILL LACOUR | 6146 CHURCHILL DOWN DR WEST LINN, OR 97068 | KAISER | — | $1K | $1K | 0.09% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA EIN 93-6021772 PPO | Claims processing Service code 12 | 701 5TH AVE, STE 4900 SEATTLE, WA 98104 | $160K |
| WILLIAM C. EARHART CO., INC. EIN 93-6021772 THIRD PARTY ADMINISTRATOR | Contract Administrator Service code 13 | 3140 NE BROADWAY ST. PORTLAND, OR 97232 | $146K |
| WILLIAM LACOUR LLC EIN 46-3675103 BENEFIT CONSULTANT | Consulting (general) Service code 16 | 6146 CHURCHILL DOWNS DR. WEST LINN, OR 97068 | $36K |
| MODA HEALTH EIN 93-1083363 CLAIMS ADMINISTRATION | Claims processing Service code 12 | 601 SW SECOND AVE PORTLAND, OR 97204 | $30K |
| BANK OF AMERICA EIN 94-1687665 INVESTMENT CUSTODIAN | Investment management Service code 28 | 121 SW MORRISON AVE PORTLAND, OR 97207 | $24K |
| LINDQUIST, LLP EIN 52-2385296 CONTRIBUTION COMPLIANCE | Accounting (including auditing) Service code 10 | 9955 SE WASHINGTON ST 20 PORTLAND, OR 97216 | $18K |
| BROWNSTEIN, RASK EIN 93-0589000 LEGAL COUNSEL | Legal Service code 29 | 1200 SW MAIN ST. PORTLAND, OR 97205 | $11K |
| BJORKLUND & MONTPLAISIR EIN 93-1015766 AUDITOR | Accounting (including auditing) Service code 10 | 9020 SW WASHINGTON SQ RD PORTLAND, OR 97201 | $8K |
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 | 627 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 627 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER | 344 | $1.4M |
| Dental | WILLAMETTE DENTAL | 658 | $206K |
| Vision | VISION SERVICE PLAN | 688 | $52K |
| Life insurance | UNITED OF OMAHA | 627 | $19K |
| Long-term disability | UNITED OF OMAHA | 627 | $19K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE CO. | 545 | $534K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 688 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.