| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF-SAWYER OREGON INC | 1001 SW 5TH AVE STE 1000 PORTLAND, OR 97204 | HARTFORD LIFE & ACCIDENT | $95K | — | $95K | 2.51% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF-SAWYER OREGON INC | 1001 SW 5TH AVE STE 1000 PORTLAND, OR 97204 | HARTFORD LIFE AND ACCIDENT | $11K | $2K | $13K | 2.79% |
| HARTFORD HOME OFFICE DIRECT3 | ONE HARTFORD PLAZA HARTFORD, CT 06155 | HARTFORD LIFE AND ACCIDENT | — | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PACIFIC SOURCE EIN 93-0245545 NONE | Contract Administrator Service code 13 | 110 INTERNATIONAL WAY SPRINGFIELD, OR 97477 | $3.7M |
| SEDGWICK CLAIMS MANAGEMENT SERVICES EIN 36-2685608 NONE | Claims processing Service code 12 | 1100 RIDGEWAY LOOP ROAD MEMPHIS, TN 38120 | $1.7M |
| MODA EIN 93-0989307 NONE | Contract Administrator Service code 13 | 601 SW 2ND AVE PORTLAND, OR 972043154 | $684K |
| MEDIMPACT HEALTHCARE SYSTEMS EIN 33-0567651 NONE | Contract Administrator Service code 13 | 10680 TREENA ST FL 5 SAN DIEGO, CA 921312447 | $437K |
| MILLIMAN EIN 91-0675641 NONE | Consulting (general); Actuarial Service code 11 | 111 SW 5TH AVE 3700 PORTLAND, OR 97204 | $289K |
| CASCADE CENTERS EIN 93-0774210 NONE | Contract Administrator Service code 13 | 7180 SW FIR LOOP 1A TIGARD, OR 972238023 | $200K |
| TOWERS WATSON EIN 23-1159360 NONE | Consulting (general) Service code 16 | PO BOX 8500 PHILADELPHIA, PA 19178 | $90K |
| COL-TAB EIN 93-0853783 NONE | Copying and duplicating Service code 36 | 1919 SE BELMONT PORTLAND, OR 972140928 | $74K |
| FIRST AMERICAN ADMINISTRATORS, INC. EIN 86-0773195 NONE | Contract Administrator Service code 13 | 14670 COLLECTIONS CENTER DRIVE CHICAGO, IL 60693 | $62K |
| SELECT ACTUARIALS EIN 62-1767300 NONE | Actuarial Service code 11 | 28 WHITE BRIDGE RD 205 NASHVILLE, TN 372051428 | $22K |
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 | 12,230 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 12,230 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | HARTFORD LIFE & ACCIDENT | 12,230 | $3.8M |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 0 | $474K |
| Other | HARTFORD LIFE AND ACCIDENT | 0 | $9K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 12,230 | — |
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.