| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MJ INSURANCE3 Filed as: MJI INC DBA HAGAN HAMILTON INSURANC | PO BOX 847 MCMINNVILLE, OR 971280847 | KAISER PERMANENTE | $28K | $652 | $28K | 2.79% |
| MJ INSURANCE3 Filed as: MJI, INC. DBA HAGAN HAMILTON INSURA | P.O. BOX 847 MCMINNVILLE MCMINNVILLE, OR 97128 | PACIFIC FURNITURE INDUSTRIES STANTON | $6K | $3K | $9K | 16.20% |
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 | 210 | 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) | 210 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER PERMANENTE | 210 | $1.0M |
| Dental | PACIFIC FURNITURE INDUSTRIES STANTON | 396 | $55K |
| Vision | PACIFIC FURNITURE INDUSTRIES STANTON | 396 | $55K |
| Life insurance | PACIFIC FURNITURE INDUSTRIES STANTON | 396 | $55K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 396 | — |
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.