| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MJ INSURANCE3 Filed as: MJI, INC. | PO BOX 847 MCMINNVILLE, OR 97128 | UNITEDHEALTHCARE INSURANCE COMPANY | $1K | $28K | $29K | 3.17% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF SAWYER OREGON, INC. | 50 CALIFORNIA STREET, 12TH FLOOR SAN FRANCISCO, CA 94111 | UNITEDHEALTHCARE INSURANCE COMPANY | $4 | $80 | $84 | 0.01% |
| MJ INSURANCE3 Filed as: MJI, INC. | PO BOX 847 MCMINNVILLE, OR 97128 | OREGON DENTAL SERVICE | $3K | — | $3K | 2.99% |
| MJ INSURANCE3 Filed as: MJI, INC. | PO BOX 847 MCMINNVILLE, OR 97128 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $2K | $8K | 18.47% |
| PINKIY WALKER3 | 13064 SE TERRA CASCADE LOOP HAPPY VALLEY, OR 97086 | AFLAC | $3K | $0 | $3K | 26.61% |
| JINX LIBERATO3 Filed as: JINX M. LIBERATO | 2821 IONE STREET SACRAMENTO, CA 95821 | AFLAC | $379 | $0 | $379 | 3.73% |
| JAMES S SARANTIS3 Filed as: JAMES S. SARANTIS | 14132 SE FIRCREST COURT PORTLAND, OR 97236 | AFLAC | $375 | $0 | $375 | 3.69% |
| MJ INSURANCE3 Filed as: MJI, INC. | PO BOX 847 MCMINNVILLE, OR 97128 | AFLAC | $370 | $0 | $370 | 3.64% |
| PAUL LANGAS3 Filed as: PAUL JON LANGAS AND OTHER AGENTS | 8910 NORTH JUNIPER STREET CAMAS, WA 98607 | AFLAC | $121 | $0 | $121 | 1.19% |
| SAHAR QABAZARD3 | 443 SOUTH MAPLE DRIVE BEVERLY HILLS, CA 90212 | AFLAC | $117 | $0 | $117 | 1.15% |
| KAREN D SHATTUCK3 Filed as: KAREN D. SHATTUCK | 1040 SOUSA COURT SPARTANBURG, SC 29307 | AFLAC | $69 | $0 | $69 | 0.68% |
| MJ INSURANCE3 Filed as: MJI, INC. | PO BOX 847 MCMINNVILLE, OR 97128 | LEGALSHIELD | $391 | — | $391 | 14.14% |
| DOUG A. SMITH4 | 2901 EAST 2ND STREET, UNIT 60 NEWBERG, OR 97132 | LEGALSHIELD | $391 | — | $391 | 14.14% |
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 | 129 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 135 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 228 | $909K |
| Dental | OREGON DENTAL SERVICE | 162 | $88K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 228 | $909K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 252 | $43K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 252 | $43K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 228 | $909K |
| Other(4 contracts, 4 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 252 | $64K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 252 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.