| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE INC | PO BOX 29 SPRINGFIELD, OR 97477 | REGENCE BLUECROSS BLUESHIELD OF OREGON | — | $2K | $2K | 0.03% |
| MJ INSURANCE3 Filed as: MJI INC | PO BOX 847 MCMINNVILLE, OR 97128 | REGENCE BLUECROSS BLUESHIELD OF OREGON | — | $1K | $1K | 0.02% |
| BH INSURANCE LLC3 | PO BOX 270 SALEM, OR 97308 | REGENCE BLUECROSS BLUESHIELD OF OREGON | — | $820 | $820 | 0.01% |
| DIVERSIFIED BENEFITS MANAGEMENT LLC3 | 7202 NE HWY 99 SUITE 106002 VANCOUVER, WA 98665 | REGENCE BLUECROSS BLUESHIELD OF OREGON | — | $520 | $520 | 0.01% |
| LARRY SHERWOOD & ASSOCIATES INC3 | 18765 SW BOONSE FERRY, SUITE 325 TUALATIN, OR 97062 | REGENCE BLUECROSS BLUESHIELD OF OREGON | — | $520 | $520 | 0.01% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: WARD INSRUANCE AGENCY | PO BOX 10167 EUGENE, OR 97440 | REGENCE BLUECROSS BLUESHIELD OF OREGON | — | $444 | $444 | 0.01% |
| CRAVINHO & JAEGER FINANCIAL SERVICE3 | PO BOX 188 SALEM, OR 97308 | REGENCE BLUECROSS BLUESHIELD OF OREGON | — | $200 | $200 | 0.00% |
| WARD INSURANCE AGENCY INC3 Filed as: WARD INSURANCE AGENCY | PO BOX 10167 EUGENE, OR 97440 | REGENCE BLUECROSS BLUESHIELD OF OREGON | — | $63 | $63 | 0.00% |
| CATHY MERZ INSURANCE INC3 | 4858B SW SCHOLLS FERRY ROAD SUITE B PORTLAND, OR 97225 | REGENCE BLUECROSS BLUESHIELD OF OREGON | — | $49 | $49 | 0.00% |
| JD FULVILLER & CO INSURANCE3 | 5727 SW MACADAM AVE PORTLAND, OR 97239 | REGENCE BLUECROSS BLUESHIELD OF OREGON | — | $28 | $28 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| JD FULWILER & CO INSURANCE, INC NONE | Direct payment from the plan; Consulting (general); Insurance brokerage commissions and fees; Insurance agents and brokers Service code 16 | 5727 SW MACADAM AVE PORTLAND, OR 97239 | $235K |
| VIMLY BENEFIT SOLUTIONS, INC. EIN 91-1603312 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $90K |
| KPD INSURANCE, INC NONE | Insurance agents and brokers; Direct payment from the plan; Insurance brokerage commissions and fees Service code 22 | PO BOX 29 SPRINGFIELD, OR 97477 | $51K |
| WARD INSURANCE AGENCY, INC. NONE | Insurance agents and brokers; Insurance brokerage commissions and fees; Direct payment from the plan Service code 22 | PO BOX 10167 EUGENE, OR 97440 | $41K |
| CONSILIUM BENEFIT ADVISORS NONE | Direct payment from the plan; Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | 10220 SW GREENBURG ROAD, SUITE 225 TIGARD, OR 97223 | $39K |
| ALDRICH BENFITS, LP NONE | Insurance brokerage commissions and fees; Insurance agents and brokers; Direct payment from the plan Service code 22 | 680 HAWTHORN AVE SE, STE 140 SALEM, OR 97301 | $32K |
| CRAVINHO & JAEGER FINANCIAL SERVICE NONE | Direct payment from the plan; Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | PO BOX 188 SALEM, OR 97308 | $29K |
| PROPEL INSURANCE NONE | Direct payment from the plan; Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | 888 SW 5TH AVE, SUITE 1170 PORTLAND, OR 97204 | $27K |
| DIVERSIFIED BENEFITS MANAGEMENT NONE | Insurance brokerage commissions and fees; Insurance agents and brokers; Direct payment from the plan Service code 22 | 7202 NE HWY 99, SUITE 106002 VANCOUVER, WA 98665 | $24K |
| CLIFTONLARSONALLEN LLP EIN 41-0746749 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $18K |
| MJI INC DBA HAGAN HAMILTON NONE | Insurance services; Insurance brokerage commissions and fees; Direct payment from the plan Service code 23 | 448 SE BAKER STREET MCMINNVILLE, OR 97128 | $17K |
| LAPORTE & ASSOCIATES INC NONE | Direct payment from the plan; Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | 5515 SE MILWAUKIE AVE PORTLAND, OR 97202 | $16K |
| BROWN & BROWN NORTHWEST INSURANCE NONE | Insurance agents and brokers; Insurance brokerage commissions and fees; Direct payment from the plan Service code 22 | FORMERLY FULLERTON AND COMPANY INC 2701 NW VAUGHN ST SUITE 340 PORTLAND, OR 97210 | $13K |
| HUB INTERNATIONAL NORTHWEST, LLC NONE | Direct payment from the plan; Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | 12100 NE 195TH ST, #200 BOTHELL, WA 98011 | $13K |
| BH INSURANCE LLC EIN 26-3896449 NONE | Insurance agents and brokers; Direct payment from the plan; Insurance brokerage commissions and fees Service code 22 | — | $11K |
| WEIS & ASSOCIATES, INC NONE | Insurance brokerage commissions and fees; Insurance agents and brokers; Direct payment from the plan Service code 22 | PO BOX 158 STAYTON, OR 97383 | $7K |
| GOLSON SCRUGGS INSURANCE INC. NONE | Direct payment from the plan; Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | 10998 SW 68TH PARKWAY PORTLAND, OR 97223 | $5K |
| ISU THE STRATTON AGENCY NONE | Legal; Direct payment from the plan; Consulting (general) Service code 16 | 435 SW DORLON AVENUE PENDLETON, OR 97801 | $5K |
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 | 809 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 813 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | REGENCE BLUECROSS BLUESHIELD OF OREGON | 2,159 | $12.7M |
| Dental | STANDARD INSURANCE COMPANY | 222 | $239K |
| Vision | STANDARD INSURANCE COMPANY | 530 | $54K |
| Life insurance(2 contracts, 2 carriers) | LIFEMAP ASSURANCE COMPANY | 1,172 | $32K |
| Prescription drug | REGENCE BLUECROSS BLUESHIELD OF OREGON | 2,159 | $8.6M |
| Other(2 contracts, 2 carriers) | LIFEMAP ASSURANCE COMPANY | 1,172 | $32K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,159 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.