| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE PARTNERS GROUP3 | 11850 SW 67TH AVE, SUITE 100 PORTLAND, OR 97223 | PROVIDENCE HEALTH PLAN | $179K | — | $179K | 4.50% |
| THE PARTNERS GROUP3 | 11850 SW 67TH AVE, SUITE 100 PORTLAND, OR 97223 | OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON | $18K | — | $18K | 4.93% |
| THE PARTNERS GROUP3 | 11225 SE 6TH ST SUITE 110 BELLEVUE, WA 98004 | HARTFORD LIFE AND ACCIDENT | $3K | — | $3K | 15.76% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| JONES & ROTH, P.C. EIN 93-0819646 AUDITOR | Accounting (including auditing) Service code 10 | — | $13K |
| OREGON SOCIETY OF CERTIFIED PUBLIC EIN 93-0462679 PLAN ADMINISTRATOR | Plan Administrator; Direct payment from the plan Service code 14 | — | $12K |
| MILLER NASH GRAHAM & DUNN, LLP EIN 93-0410518 ATTORNEY | Legal Service code 29 | — | $879 |
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 | 357 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 357 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PROVIDENCE HEALTH PLAN | 342 | $4.0M |
| Dental | OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON | 357 | $361K |
| Vision | PROVIDENCE HEALTH PLAN | 342 | $4.0M |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 50 | $19K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 357 | — |
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.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.