| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 601 SW 2ND AVE, STE 1200 CLAUDE CAMPBELL PORTLAND, OR 97204 | PACIFICSOURCE HEALTH PLANS | $61K | — | $61K | 2.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF OR | PO BOX 29018 TIMOTHY COOPER PORTLAND, OR 97296 | PACIFICSOURCE HEALTH PLANS | $22K | — | $22K | 0.73% |
| MERCER HEALTH AND BENEFITS, LLC3 | 111 SW COLUMBIA ST STE 500 JENNIFER A CHISHOLM PORTLAND, OR 97201 | PACIFICSOURCE HEALTH PLANS | $15K | — | $15K | 0.48% |
| MERCER HEALTH AND BENEFITS, LLC3 | 111 SW COLUMBIA ST STE 500 ROBERT VALDEZ PORTLAND, OR 97201 | PACIFICSOURCE HEALTH PLANS | $6K | — | $6K | 0.21% |
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH ST STE 700 MINNEAPOLIS, MN 55402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $2K | $5K | 4.18% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF OREGON LLC | PO BOX 29018 PORTLAND, OR 97296 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $408 | $4K | 2.96% |
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH ST STE 700 MINNEAPOLIS, MN 55402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $855 | $7K | 9.79% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF OREGON LLC | PO BOX 29018 PORTLAND, OR 97296 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $226 | $3K | 3.96% |
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH ST STE 700 MINNEAPOLIS, MN 55402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $643 | $5K | 10.05% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF OR | PO BOX 29018 PORTLAND, OR 97296 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $170 | $2K | 4.06% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $34 | $1K | 2.83% |
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH ST STE 700 MINNEAPOLIS, MN 55402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $82 | — | $82 | 0.22% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF OREGON | PO BOX 29018 PORTLAND, OR 97296 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10 | — | $10 | 0.03% |
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 | 232 | 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) | 232 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PACIFICSOURCE HEALTH PLANS | 201 | $3.1M |
| Dental | PACIFICSOURCE HEALTH PLANS | 201 | $3.1M |
| Vision | PACIFICSOURCE HEALTH PLANS | 201 | $3.1M |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 236 | $206K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 95 | $54K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 236 | $131K |
| Prescription drug | PACIFICSOURCE HEALTH PLANS | 201 | $3.1M |
| Other(4 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 238 | $248K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 238 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.