| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MEGAN M. THORNTON3 | NORTHWEST BENEFIT STRATEGIES, LLC 21370 SW LANGER FARMS PKWY STE 142 SHERWOOD, OR 97140 | PACIFICSOURCE HEALTH PLANS | $20K | $0 | $20K | 2.24% |
| SCOTT LYDA3 | MONTGOMERY AND GRAHAM INC 412 JEFFERSON PKWY STE 100 LAKE OSWEGO, OR 97035 | PACIFICSOURCE HEALTH PLANS | $8K | $0 | $8K | 0.90% |
| MONTGOMERY & GRAHAM INC3 Filed as: MONTGOMERY AND GRAHAM INC | 412 JEFFERSON PKWY STE 100 LAKE OSWEGO, OR 97035 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $27 | $2K | 7.79% |
| NORTHWEST BENEFIT STRATEGIES LLC3 | 21370 SW LANGER FARMS PKWY SHERWOOD, OR 97140 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $910 | $0 | $910 | 3.54% |
| MONTGOMERY & GRAHAM INC3 | 412 JEFFERSON PARKWAY #100 LAKE OSWEGO, OR 97035 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $374 | $0 | $374 | 1.46% |
| NORTHWEST BENEFIT STRATEGIES LLC3 | 21370 SW LANGER FARMS PKWY SHERWOOD, OR 97140 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $732 | $0 | $732 | 10.90% |
| MONTGOMERY & GRAHAM INC3 | 412 JEFFERSON PARKWAY #100 LAKE OSWEGO, OR 97035 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $275 | $0 | $275 | 4.10% |
| NORTHWEST BENEFIT STRATEGIES LLC3 | 21370 SW LANGER FARMS PKWY SHERWOOD, OR 97140 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $713 | $0 | $713 | 10.66% |
| MONTGOMERY & GRAHAM INC3 | 412 JEFFERSON PARKWAY #100 LAKE OSWEGO, OR 97035 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $290 | $0 | $290 | 4.34% |
| NORTHWEST BENEFIT STRATEGIES LLC3 | 21370 SW LANGER FARMS PKWY SHERWOOD, OR 97140 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $171 | $0 | $171 | 10.90% |
| MONTGOMERY & GRAHAM INC3 | 412 JEFFERSON PARKWAY #100 LAKE OSWEGO, OR 97035 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $64 | $0 | $64 | 4.08% |
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 | 100 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 100 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PACIFICSOURCE HEALTH PLANS | 95 | $885K |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 179 | $54K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 179 | $28K |
| Life insurance(3 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 179 | $36K |
| Short-term disability(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 179 | $35K |
| Other(3 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 179 | $36K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 179 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.