No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CYPRESS BENEFIT ADMINISTRATORS, LLC EIN 39-1997579 NONE | Plan Administrator; Claims processing Service code 12 | 5560 WEST GRANDE MARKET DR APPLETON, WI 54913 | $637K |
| CIGNA EIN 59-1031071 NONE | Claims processing Service code 12 | PO BOX 645014 CINCINNATI, OH 452645014 | $242K |
| MILLIMAN EIN 91-0675641 NONE | Actuarial Service code 11 | 1301 FIFTH AVE SUITE 3800 SEATTLE, WA 97101 | $48K |
| UNIFIED GROCERS INSURANCE SERVICES EIN 95-2106800 NONE | Insurance services Service code 23 | PO BOX 3763 SEATTLE, WA 98124 | $32K |
| BULLIVANT HOUSER EIN 93-1129534 NONE | Legal Service code 29 | 888 SW FIFTH AVE PORTLAND, OR 97204 | $28K |
| RISK POINT INSURANCE ADVISORS EIN 27-1369286 NONE | Finders' fees / placement fees Service code 61 | 965 SW EMKAY DR BEND, OR 97702 | $24K |
| PACIFIC NORTHWEST HARDWARE EIN 91-0353247 NONE | Finders' fees / placement fees Service code 61 | PO BOX 17819 SALEM, OR 97305 | $24K |
| KERN & THOMPSON, LLC EIN 93-1157146 NONE | Accounting (including auditing) Service code 10 | 1800 SW FIRST AVENUE SUITE 410 PORTLAND, OR 97201 | $21K |
| DOCUMART COPIES & PRINTING EIN 73-1370958 NONE | Copying and duplicating Service code 36 | 728 SW WASHINGTON ST PORTLAND, OR 97205 | $15K |
| HOPE HEALTH EIN 38-1784210 NONE | Claims processing Service code 12 | 350 EAST MICHIGAN AVE SUITE 225 KALAMAZOO, MI 79007 | $7K |
| DEPARTMENT OF CONSUMER & BUSINESS EIN 93-0952020 NONE | Accounting (including auditing) Service code 10 | 350 WINTER ST NE ROOM 27 SALEM, OR 97301 | $6K |
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 | 1,736 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 22 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | STANDARD INSURANCE COMPANY | 1,654 | $104K |
| Short-term disability | STANDARD INSURANCE COMPANY | 1,654 | $104K |
| Long-term disability | STANDARD INSURANCE COMPANY | 1,654 | $104K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,654 | — |
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."
Filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported — worth a knock.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.