| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RICH COHEN3 Filed as: RICH LALOR | 465 COVEY LANE EUGENE, OR 97401 | MODA HEALTH | $14K | — | $14K | 2.16% |
| GCG FINANCIAL LLC3 Filed as: DAVIDSON BENEFITS ALERA GROUP | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | MODA HEALTH | $1K | — | $1K | 0.17% |
| THE PARTNERS GROUP3 Filed as: THE PARTNERS GROUP LTD | 5 CENTERPOINTE STE 500 LAKE OSWEGO, OR 97035 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 8.66% |
| RHODES WARDEN INS AGCY3 Filed as: RHODES WARDEN INS INC | 2545 SOUTH SECOND ST PO BOX 8 LEBANON, OR 97355 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | -$4K | — | -$4K | -3.96% |
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 | 104 | 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) | 104 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MODA HEALTH | 137 | $650K |
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 103 | $93K |
| Vision | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 103 | $93K |
| Life insurance | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 103 | $93K |
| Prescription drug | MODA HEALTH | 137 | $650K |
| Other | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 103 | $93K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 137 | — |
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.