| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES, USA | PO BOX 4100 MAIL STOP 86 PORTLAND, OR 97208 | OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON | $3K | — | $3K | 1.66% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK, INC. | 1 WORLD FINANCIAL CENTER 200 LIBERTY ST, 6TH FL. NEW YORK, NY 10281 | OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON | $1K | — | $1K | 0.84% |
| ALTERITY GROUP3 | 340 MADISON AVE 21ST FL. NEW YORK, NY 10173 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $2K | $5K | 4.96% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS. SVCS | PO BOX 203334 FLORIDA LOCKBOX DALLAS, TX 75320 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $19 | $2K | 1.95% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC. | ONE WORLD FINANCIAL CENTER 200 LIBERTY ST NEW YORK, NY 10281 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $888 | — | $888 | 0.82% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS. SVCS USA, INC. | PO BOX 201629 DALLAS, TX 75320 | VISION SERVICE PLAN | $913 | — | $913 | 3.32% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC. | 1 WORLD FINANCIAL CTR NEW YORK, NY 10281 | VISION SERVICE PLAN | $460 | — | $460 | 1.67% |
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 | 398 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 17 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 420 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON | 296 | $171K |
| Vision | VISION SERVICE PLAN | 293 | $27K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 398 | $108K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 398 | $108K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 398 | $108K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 398 | — |
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."
No prospect flags tripped on this filing.