| 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 | $15K | — | $15K | 2.40% |
| BEND INSURANCE AGENCY3 | 550 NW FRANKLIN AVENUE, SUITE 268 BEND, OR 97702 | PACIFICSOURCE HEALTH PLANS | $5K | — | $5K | 0.89% |
| CENTURY INSURANCE GROUP LLC3 Filed as: CENTURY INSURANCE GROUP LLC, | 572 SW BLUFF DRIVE, SUITE 100, BEND, OR 97702 | PACIFICSOURCE HEALTH PLANS | $3K | — | $3K | 0.53% |
| HEALTH INSURANCE STRATEGIES, INC.3 Filed as: HEALTH INSURANCE STRATEGIES INC., | 400 SW BLUFF DRIVE, SUITE 103 BEND, OR 97702 | PACIFICSOURCE HEALTH PLANS | $2K | — | $2K | 0.36% |
| CASCADE INSURANCE CENTER LLC3 | 336 SW CYBER DRIVE, SUITE D-104 BEND, OR 97702 | PACIFICSOURCE HEALTH PLANS | $2K | — | $2K | 0.31% |
| CENTRAL OREGON EMPLOYEE BENEFITS3 Filed as: CENTRAL OREGON EMPLOYEE BFTS., LLC | 61130 HILMER CREEK DRIVE, BEND, OR 97702 | PACIFICSOURCE HEALTH PLANS | $1K | — | $1K | 0.20% |
| JACKSON INS. AND FINANCIAL SERVICES3 | 17 NW HAWTHORNE, SUITE 1 BEND, OR 97702 | PACIFICSOURCE HEALTH PLANS | $847 | — | $847 | 0.14% |
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 | 104 | 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) | 104 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PACIFICSOURCE HEALTH PLANS | 186 | $611K |
| Dental | PACIFICSOURCE HEALTH PLANS | 186 | $611K |
| Vision | PACIFICSOURCE HEALTH PLANS | 186 | $611K |
| Prescription drug | PACIFICSOURCE HEALTH PLANS | 186 | $611K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 186 | — |
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.