| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF OREGON, LLC | 941 OAK STREET EUGENE, OR 97401 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $55K | $6K | $61K | 3.04% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF OREGON, LLC | 941 OAK STREET EUGENE, OR 97401 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $13K | $0 | $13K | 3.59% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF OREGON LLC | 5005 MEADOWS ROAD, SUITE 402 LAKE OSWEGO, OR 97035 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $12K | $6K | $18K | 11.15% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF OREGON, LLC | 941 OAK STREET EUGENE, OR 97401 | PACIFICSOURCE HEALTH PLANS | $4K | $0 | $4K | 2.35% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF SAWYER AND COMPANY | 50 CALIFORNIA STREET, 12TH FLOOR SAN FRANCISCO, CA 94111 | PACIFICSOURCE HEALTH PLANS | $221 | $0 | $221 | 0.15% |
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 | 879 | 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) | 879 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 262 | $2.5M |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 809 | $158K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 809 | $158K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 809 | $158K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 262 | $2.4M |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 809 | $162K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 809 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.