| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| J.L. JONES AND ASSOCIATES3 | 720 COUNTRY CLUB ROAD EUGENE, OR 97401 | BLUE CROSS OF IDAHO HEALTH SERVICE, INC. | $44K | — | $44K | 3.55% |
| J.L. JONES AND ASSOCIATES3 | 720 COUNTRY CLUB ROAD EUGENE, OR 97401 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $16K | — | $16K | 11.45% |
| J.L. JONES AND ASSOCIATES3 | 720 COUNTRY CLUB ROAD EUGENE, OR 97401 | VISION SERVICE PLAN | $5K | — | $5K | 5.81% |
| JOANNE GARWOOD3 | 178 PALM HARBOR DRIVE NORTH PORT, FL 34287 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $178 | — | $178 | 2.38% |
| SVEND NILSSON3 | 1220 JACOBS DRIVE EUGENE, OR 97402 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $145 | — | $145 | 1.94% |
| SHEILAH RUND3 | 7395 OFFENHAUSER DRIVE RENO, NV 89511 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $19 | — | $19 | 0.25% |
| DAMON RAY OGIER3 | 731 BROOKSIDE CIRCLE ROUGE RIVER, OR 97537 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $18 | — | $18 | 0.24% |
| THOMAS M. TAYLOR3 | 1126 GATEWAY LOOP SPRINGFIELD, OR 97477 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $16 | — | $16 | 0.21% |
| ZINA OSTER3 | 3153 FOREST DRIVE CHEYENNE, WY 82001 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.15% |
| PREMIER WORKSITE SOLUTIONS INC3 | 806 NW 79TH STREET VANCOUVER, WA 98665 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $9 | — | $9 | 0.12% |
| J.L. JONES AND ASSOCIATES3 | 720 COUNTRY CLUB ROAD EUGENE, OR 97401 | ZURICH AMERICAN INSURANCE COMPANY | $816 | — | $816 | 15.00% |
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 | 1,703 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,703 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 4 carriers) | PACIFICSOURCE HEALTH PLANS | 1,703 | $4.2M |
| Dental | MODA, INC. | 1,703 | $0 |
| Vision | VISION SERVICE PLAN | 691 | $78K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 377 | $142K |
| Long-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 12 | $7K |
| Prescription drug(2 contracts, 2 carriers) | PACIFICSOURCE HEALTH PLANS | 671 | $4.2M |
| Other(4 contracts, 4 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,703 | $147K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,703 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.