| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOHNSON BENEFIT GROUP, INC.3 | 21550 WILIMETTE DRIVE WEST LINN, OR 97068 | PACIFICSOURCE HEALTH PLANS | $156K | — | $156K | 1.35% |
| GOSSARD AND ASSOCIATES, INC.3 | 3485 WEST 1ST AVENUE EUGENE, OR 97402 | PACIFICSOURCE HEALTH PLANS | $151K | — | $151K | 1.30% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE AND PRENTICE HOLDING COMPANY | 975 OAK STREET, SUITE 900 EUGENE, OR 97401 | PACIFICSOURCE HEALTH PLANS | $104K | — | $104K | 0.90% |
| CAMPBELL, GAULT AND NEWLAND3 | 975 OAK STREET, SUITE 900 EUGENE, OR 97401 | PACIFICSOURCE HEALTH PLANS | $77K | — | $77K | 0.66% |
| MJ INSURANCE3 Filed as: CASCADE PACIFIC AND VARIOUS AGENTS | 1500 VALLEY RIVER DRIVE, SUITE 320 EUGENE, OR 97401 | PACIFICSOURCE HEALTH PLANS | $50K | — | $50K | 0.44% |
| MATTECHECK & ASSOCIATES3 Filed as: MATTECHECK & ASSOCIATES, INC. | 610 S.W. ALDER STREET, SUITE 310 PORTLAND, OR 97205 | PACIFICSOURCE HEALTH PLANS | $20K | — | $20K | 0.17% |
| BARKER-UERLINGS INSURANCE3 Filed as: BARKER UERLINGS INSURANCE, INC. | 340 NW FIFTH STREET CORVALLIS, OR 97330 | PACIFICSOURCE HEALTH PLANS | $19K | — | $19K | 0.17% |
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 | 1,146 | 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) | 1,146 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PACIFICSOURCE HEALTH PLANS | 2,151 | $11.6M |
| Dental | PACIFICSOURCE HEALTH PLANS | 2,151 | $11.6M |
| Prescription drug | PACIFICSOURCE HEALTH PLANS | 2,151 | $11.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,151 | — |
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.