| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI NORTHWEST | 975 OAK STREET, SUITE 900 EUGENE, OR 97401 | PACIFICSOURCE HEALTH PLANS | $87K | — | $87K | 1.37% |
| JOHNSON BENEFIT GROUP, INC.3 Filed as: JOHNSON BENEFIT GROUP | 777 NW WALL STREET, SUITE 100 BEND, OR 97703 | PACIFICSOURCE HEALTH PLANS | $73K | — | $73K | 1.14% |
| GOSSARD AND ASSOCIATES, INC.3 | 3485 WEST FIRST AVENUE EUGENE, OR 97402 | PACIFICSOURCE HEALTH PLANS | $72K | — | $72K | 1.13% |
| ALLIANCE INSURANCE PARTNERS3 | 941 OAK STREET EUGENE, OR 97401 | PACIFICSOURCE HEALTH PLANS | $21K | — | $21K | 0.33% |
| CASCADE PACIFIC FINANCIAL3 Filed as: CASCADE PACIFIC FINANCE | 1500 VALLEY RIVER DRIVE, SUITE 320 EUGENE, OR 97401 | PACIFICSOURCE HEALTH PLANS | $14K | — | $14K | 0.22% |
| MATTECHECK & ASSOCIATES3 Filed as: MATTECHECK & ASSOCIATES, INC. | 610 S.W. ALDER STREET, SUITE 310 PORTLAND, OR 97205 | PACIFICSOURCE HEALTH PLANS | $8K | — | $8K | 0.13% |
| BARKER-UERLINGS INSURANCE3 Filed as: BARKER UERLINGS INSURANCE, INC. | 340 NW FIFTH STREET CORVALLIS, OR 97330 | PACIFICSOURCE HEALTH PLANS | $7K | — | $7K | 0.12% |
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 | 1,685 | 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) | 1,685 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PACIFICSOURCE HEALTH PLANS | 2,748 | $6.4M |
| Dental | PACIFICSOURCE HEALTH PLANS | 2,748 | $6.4M |
| Prescription drug | PACIFICSOURCE HEALTH PLANS | 2,748 | $6.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,748 | — |
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.