| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CASCADE EAST BENEFITS, INC.3 | 777 NW WALL STREET, SUITE 100 BEND, OR 97703 | PACIFICSOURCE HEALTH PLANS | $87K | — | $87K | 2.68% |
| CENTURY INSURANCE GROUP LLC3 Filed as: CENTURY INSURANCE GROUP, LLC | 572 SW BLUFF DRIVE, SUITE 100 BEND, OR 97702 | PACIFICSOURCE HEALTH PLANS | $21K | — | $21K | 0.66% |
| CASCADE INSURANCE CENTER LLC3 Filed as: CASCADE INSURANCE CENTER, LLC | 336 SW CYBER DRIVE, SUITE D-104, BEND, OR 97702 | PACIFICSOURCE HEALTH PLANS | $10K | — | $10K | 0.32% |
| JACKSON INS. AND FINANCIAL SERVICES3 Filed as: JACKSON INSURANCE AND FIN. SVCS. | 17 NW HAWTHORNE AVENUE, SUITE 1 BEND, OR 97702 | PACIFICSOURCE HEALTH PLANS | $7K | — | $7K | 0.22% |
| JOHNSON BENEFIT GROUP, INC.3 | 21550 WILLAMETTE DRIVE WEST LINN, OR 97068 | PACIFICSOURCE HEALTH PLANS | $7K | — | $7K | 0.21% |
| BEND INSURANCE AGENCY3 | 550 NW FRANKLIN AVENUE, SUITE 268 BEND, OR 97702 | PACIFICSOURCE HEALTH PLANS | $6K | — | $6K | 0.18% |
| WALDO INSURANCE, INC.3 | 267 A STREET WEST VALE, OR 97918 | PACIFICSOURCE HEALTH PLANS | $4K | — | $4K | 0.13% |
| JR PRICE AND ASSOCIATES, INC.3 | 1603 WASHINGTON AVENUE LA GRAND, OR 97850 | PACIFICSOURCE HEALTH PLANS | $3K | — | $3K | 0.10% |
| HIGH DESERT INSURANCE GROUP, LLC3 | 1543 NE 3RD STREET, SUITE 100 BEND, OR 97701 | PACIFICSOURCE HEALTH PLANS | $3K | — | $3K | 0.09% |
| JAD BENEFIT SOLUTIONS3 | PO BOX 5068 BEND, OR 97708 | PACIFICSOURCE HEALTH PLANS | $3K | — | $3K | 0.08% |
| BOB HART INSURANCE INC3 Filed as: BOB HART INSURANCE, INC. | 321 I STREET GRANTS PASS, OR 97526 | PACIFICSOURCE HEALTH PLANS | $2K | — | $2K | 0.07% |
| ENROLLEASE3 Filed as: CLARKE AND CLARKE FINANCIAL, INC. | 1950 CHURCH STREET BAKER CITY, OR 97814 | PACIFICSOURCE HEALTH PLANS | $1K | — | $1K | 0.04% |
| WHEATLAND FINANCIAL SERVICES, LLC3 | 229 SW FIRST PENDLETON, OR 97801 | PACIFICSOURCE HEALTH PLANS | $792 | — | $792 | 0.02% |
| CASCADE INSURANCE CENTER LLC3 Filed as: CASCADE SUMMIT INS. OF OR, INC. | 598 NW HILL STREET BEND, OR 97703 | PACIFICSOURCE HEALTH PLANS | $362 | — | $362 | 0.01% |
| HEALTH INSURANCE STRATEGIES, INC.3 | 400 SW BLUFF DRIVE, SUITE 10, BEND, OR 97702 | PACIFICSOURCE HEALTH PLANS | $98 | — | $98 | 0.00% |
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 | 502 | 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) | 502 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PACIFICSOURCE HEALTH PLANS | 796 | $3.3M |
| Dental | PACIFICSOURCE HEALTH PLANS | 796 | $3.3M |
| Vision | PACIFICSOURCE HEALTH PLANS | 796 | $3.3M |
| Prescription drug | PACIFICSOURCE HEALTH PLANS | 796 | $3.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 796 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.