| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CASCADE EAST BENEFITS, INC.3 | 777 NW WALL STREET, SUITE 100 BEND, OR 97702 | PACIFICSOURCE HEALTH PLANS | $25K | — | $25K | 2.63% |
| CASCADE INSURANCE CENTER LLC3 Filed as: CASCADE SUMMIT INS. OF OREGON, INC. | 4500 KRUSE WAY WEST LINN, OR 97035 | PACIFICSOURCE HEALTH PLANS | $11K | — | $11K | 1.19% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF OREGON, INC. | 550 NW FRANKLIN AVENUE, SUITE 268 BEND, OR 97703 | PACIFICSOURCE HEALTH PLANS | $5K | — | $5K | 0.50% |
| JACKSON INS. AND FINANCIAL SERVICES3 | 17 NW HAWTHORNE AVENUE, SUITE 1 BEND, OR 97701 | PACIFICSOURCE HEALTH PLANS | $902 | — | $902 | 0.09% |
| BEND INSURANCE AGENCY3 | 550 NW FRANKLIN AVENUE, SUITE 268 BEND, OR 97702 | PACIFICSOURCE HEALTH PLANS | $789 | — | $789 | 0.08% |
| HEALTH INSURANCE STRATEGIES, INC.3 | 400 SW BLUFF DRIVE, SUITE 100 BEND, OR 97702 | PACIFICSOURCE HEALTH PLANS | $492 | — | $492 | 0.05% |
| CENTURY INSURANCE GROUP LLC3 Filed as: CENTURY INSURANCE GROUP, LLC | 695 SW MILL VIEW WAY, SUITE 100 BEND, OR 97702 | PACIFICSOURCE HEALTH PLANS | $430 | — | $430 | 0.04% |
| WHEATLAND FINANCIAL SERVICES, LLC3 | 815 SOUTHWEST COURT AVENUE PENDLETON, OR 97801 | PACIFICSOURCE HEALTH PLANS | $413 | — | $413 | 0.04% |
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 | 160 | 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) | 160 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PACIFICSOURCE HEALTH PLANS | 245 | $964K |
| Dental | PACIFICSOURCE HEALTH PLANS | 245 | $964K |
| Vision | PACIFICSOURCE HEALTH PLANS | 245 | $964K |
| Prescription drug | PACIFICSOURCE HEALTH PLANS | 245 | $964K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 245 | — |
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.