| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIAM DOUGLAS LACOUR3 | 6146 CHURCHILL DOWNS DR WEST LINN, OR 97068 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $60K | $6K | $66K | 1.09% |
| WILLIAM D LACOUR3 Filed as: WILLIAM LACOUR | 3889 N SIDNEY ST BUCKEYE, AZ 85396 | RELIANCE STANDARD INSURANCE COMPANY | $777 | — | $777 | 15.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| NORTHWEST ADMINISTRATORS, INC. EIN 91-0680697 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $597K |
| CIGNA EIN 93-6021772 NONE | Float revenue; Named fiduciary; Other services; Direct payment from the plan; Contract Administrator; Non-monetary compensation; Claims processing; Participant communication Service code 12 | — | $473K |
| MILLER NASH GRAHAM & DUNN LLP EIN 93-0410518 NONE | Legal; Direct payment from the plan Service code 29 | — | $446K |
| MODA HEALTH EIN 93-0438772 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $141K |
| HORIZON ACTUARIAL SERVICES, LLC EIN 26-1370698 NONE | Actuarial; Consulting (general) Service code 11 | — | $112K |
| KROGER PRESCRIPTION PLAN EIN 20-5927634 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $98K |
| US BANK EIN 93-0571729 NONE | Custodial (securities); Trustee (bank, trust company, or similar financial institution); Direct payment from the plan Service code 19 | 555 SW OAK ST PORTLAND, OR 97208 | $74K |
| WINTHUM SMITH + BROWN, PC EIN 22-2027092 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $41K |
| VERUS ADVISORY, INC. EIN 91-1320111 NONE | Consulting (pension); Investment advisory (plan); Direct payment from the plan Service code 17 | — | $35K |
| MZQ CONSULTING, LLC EIN 38-4010278 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $31K |
| WELLS FARGO BANK EIN 94-1347393 NONE | Direct payment from the plan; Custodial (other than securities); Investment management Service code 18 | — | $25K |
| MILLER KAPLAN ARASE LLP EIN 95-2036255 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $25K |
| METRO PRESORT INC EIN 93-0799990 NONE | Other services; Copying and duplicating; Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $16K |
| BARLOW & COUGHRAN, PS EIN 91-1008931 NONE | Legal; Direct payment from the plan Service code 29 | — | $10K |
| TURNER, STOEVE & GAGLIARDI, P.S. EIN 91-1282506 NONE | Legal; Direct payment from the plan Service code 29 | — | $7K |
| MILLIMAN USA EIN 91-0675641 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $7K |
| CAPITOL CITY PRESS, INC EIN 91-1068832 NONE | Copying and duplicating; Direct payment from the plan; Other services Service code 36 | — | $7K |
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 | 1,721 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 516 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,237 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | PROVIDENCE HEALTH PLAN | 1,272 | $12.8M |
| Vision | VSP | 2,233 | $173K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 0 | $0 |
| Other | RELIANCE STANDARD INSURANCE COMPANY | 1,489 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,233 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.