| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF OREGON LLC | 2701 NW VAUGHN ST. #340 PORTLAND, OR 97210 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $20K | $609 | $21K | 2.35% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN NORTHWEST | 2701 NW VAUGHN, SUITE 340 PORTLAND, OR 97210 | WILLAMETTE DENTAL INSURANCE, INC | $1K | $4K | $5K | 14.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN NORTHWEST | P O BOX 29018 PORTLAND, OR 97210 | OREGON DENTAL SERVICE (MODA HEALTH) | $882 | — | $882 | 2.79% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF OREGON LLC | P O BOX 29018 PORTLAND, OR 972960018 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $218 | $2K | 11.25% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN NORTHWEST | P O BOX 29018 PORTLAND, OR 97296 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $819 | $54 | $873 | 15.98% |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 0 | $875K |
| Dental(2 contracts, 2 carriers) | WILLAMETTE DENTAL INSURANCE, INC | 97 | $67K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 29 | $23K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 0 | $17K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 0 | $875K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 0 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 97 | — |
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.