| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CASCADE INSURANCE CENTER LLC3 Filed as: CASCADE EAST DBA JOHNSON BEN. PLAN. | UNKNOWN BEND, OR 97703 | PACIFICSOURCE HEALTH PLANS | $71K | $0 | $71K | 2.03% |
| JOHNSON BENEFIT GROUP, INC.3 | UNKNOWN BEND, OR 97703 | PACIFICSOURCE HEALTH PLANS | $45K | $0 | $45K | 1.30% |
| MJ INSURANCE3 Filed as: DARRIN MICHAE BEEH & VARIOUS AGENTS | UNKNOWN BEND, OR 97703 | PACIFICSOURCE HEALTH PLANS | $16K | $0 | $16K | 0.47% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE INC. | UNKNOWN BEND, OR 97703 | PACIFICSOURCE HEALTH PLANS | $13K | $0 | $13K | 0.37% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE AND PRENTICE HOLDING DBA USI | UNKNOWN BEND, OR 97703 | PACIFICSOURCE HEALTH PLANS | $10K | $0 | $10K | 0.28% |
| BARKER UERINGS INSURANCE, INC.3 | UNKNOWN BEND, OR 97703 | PACIFICSOURCE HEALTH PLANS | $8K | $0 | $8K | 0.22% |
| JACKSON INSURANCE AND FIN. SERVICES3 Filed as: JACKSON INSURANCE AND FIN. SERV. | UNKNOWN BEND, OR 97703 | PACIFICSOURCE HEALTH PLANS | $7K | $0 | $7K | 0.21% |
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 | 420 | 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) | 420 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PACIFICSOURCE HEALTH PLANS | 696 | $3.5M |
| Dental | PACIFICSOURCE HEALTH PLANS | 696 | $3.5M |
| Vision | PACIFICSOURCE HEALTH PLANS | 696 | $3.5M |
| Prescription drug | PACIFICSOURCE HEALTH PLANS | 696 | $3.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 696 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
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.