| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DAVEVIC BENEFIT CONSULTANTS, INC.3 Filed as: DAVEVIC BENEFIT CONSULTANTS | PO BOX 976 GROVE CITY, PA 16127 | OREGON BUSINESS & INDUSTRY HEALTHCHOICE BENEFITS | $52K | — | $52K | 3.50% |
| THE PARTNERS GROUP3 Filed as: THE PARTNERS GROUP LTD | 11850 SW 67TH AVE SUITE 100 PORTLAND, OR 97223 | OREGON BUSINESS & INDUSTRY HEALTHCHOICE BENEFITS | $45K | — | $45K | 3.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NW LLC | PO BOX 1378 CORVALLIS, OR 97339 | STANDARD INSURANCE COMPANY | $1K | $909 | $2K | 1.82% |
| DAVEVIC BENEFIT CONSULTANTS, INC.3 Filed as: DAVEVIC BENEFIT CONSULTANTS | PO BOX 976 GROVE CITY, PA 16127 | STANDARD INSURANCE COMPANY | $1K | — | $1K | 1.28% |
| DAVEVIC BENEFIT CONSULTANTS, INC.3 Filed as: DAVEVIC BENEFIT CONSULTANTS | PO BOX 976 902 S CENTER STREET GROVE CITY, PA 16127 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 8.77% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 6979 SE LAKE ROAD PORTALND, OR 97267 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $397 | $2K | 2.87% |
| DAVEVIC BENEFIT CONSULTANTS, INC.3 Filed as: DAVEVIC BENEFIT CONSULTANTS | PO BOX 976 GROVE CITY, PA 16127 | STANDARD INSURANCE COMPANY | $320 | — | $320 | 1.27% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NW LLC | PO BOX 1378 CORVALLIS, OR 97339 | STANDARD INSURANCE COMPANY | $115 | $59 | $174 | 0.69% |
| DAVEVIC BENEFIT CONSULTANTS, INC.3 Filed as: DAVEVIC BENEFIT CONSULTANTS | PO BOX 976 902 S CENTER STREET GROVE CITY, PA 16127 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 12.71% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 6979 SE LAKE ROAD PORTALND, OR 97267 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $710 | $136 | $846 | 3.74% |
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 | 206 | 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) | 206 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | OREGON BUSINESS & INDUSTRY HEALTHCHOICE BENEFITS | 347 | $1.5M |
| Dental | STANDARD INSURANCE COMPANY | 199 | $107K |
| Vision | STANDARD INSURANCE COMPANY | 391 | $25K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 206 | $68K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 206 | $68K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 206 | $68K |
| Prescription drug | OREGON BUSINESS & INDUSTRY HEALTHCHOICE BENEFITS | 347 | $1.5M |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 206 | $91K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 391 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.