| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF OREGON LLC | PO BOX 743061 LOS ANGELES, CA 90074 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | — | $2K | $2K | 0.09% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF OREGON LLC | PO BOX 29018 PORTLAND, OR 97296 | LIFEMAP ASSURANCE COMPANY | $28K | — | $28K | 8.04% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| REGENCE BLUECROSS BLUESHIELD OF OR EIN 93-0238155 NONE | Non-monetary compensation; Claims processing; Insurance brokerage commissions and fees; Direct payment from the plan; Contract Administrator; Other services; Other fees; Float revenue Service code 12 | — | $484K |
| JODI AMATO EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | PO BOX 2321 LAKE OSWEGO, OR 970350666 | $96K |
| OREGON DENTAL SERVICE EIN 93-0438772 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $55K |
| BROWN & BROWN OF OREGON, LLC EIN 93-0518576 NONE | Insurance agents and brokers; Direct payment from the plan Service code 22 | — | $46K |
| IAFF LOCAL 1660 EIN 93-0593668 PLAN SPONSOR | Direct payment from the plan; Other services Service code 49 | — | $42K |
| MORGAN STANLEY NONE | Investment management; Investment management fees paid directly by plan Service code 28 | 1585 BROADWAY AVENUE NEW YORK, NY 10036 | $41K |
| WITHUMSMITH+BROWN, PC EIN 22-2027092 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $32K |
| BENEFITELECT, INC. EIN 47-2294586 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $29K |
| BENEFIT PLAN ADMIN SERVICES INC. EIN 16-1503696 NONE | Investment management; Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Trustee (directed) Service code 15 | — | $28K |
| LIFEMAP ASSURANCE COMPANY EIN 93-6030398 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $21K |
| BARRAN LIEBMAN, LLP EIN 93-1251627 NONE | Legal; Direct payment from the plan Service code 29 | — | $12K |
| ALLEGIANCE NONE | Direct payment from the plan; Other services Service code 49 | 2806 S. GARFIELD ST. P.O. BOX 20907 MISSOULA, MT 59806 | $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 | 656 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 74 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 730 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 1,849 | $3.6M |
| Life insurance | LIFEMAP ASSURANCE COMPANY | 495 | $353K |
| Short-term disability | LIFEMAP ASSURANCE COMPANY | 495 | $353K |
| Long-term disability | LIFEMAP ASSURANCE COMPANY | 495 | $353K |
| Stop-loss / reinsurancereinsurance | COMMENCEMENT BAY RISK MANAGEMENT INSURANCE COMPANY | 1,849 | $1.2M |
| Other | LIFEMAP ASSURANCE COMPANY | 495 | $353K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,849 | — |
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.