| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 975 OAK STREET, SUITE 900 EUGENE, OR 97401 | PACIFICSOURCE HEALTH PLANS | $163K | $0 | $163K | 1.83% |
| GOSSARD AND ASSOCIATES, INC.3 | UNKNOWN MEDFORD, OR 97501 | PACIFICSOURCE HEALTH PLANS | $114K | $0 | $114K | 1.29% |
| JOHNSON BENEFIT GROUP, INC.3 | UKNOWN MEDFORD, OR 97501 | PACIFICSOURCE HEALTH PLANS | $55K | $0 | $55K | 0.62% |
| BARKER UERILINGS INSURANCE. INC.3 | UKNOWN MEDFORD, OR 97501 | PACIFICSOURCE HEALTH PLANS | $21K | $0 | $21K | 0.24% |
| WARD INSURANCE AGENCY INC3 Filed as: WARD INSURANCE AGENCY, INC. | UNKNOWN MEDFORD, OR 97501 | PACIFICSOURCE HEALTH PLANS | $12K | $0 | $12K | 0.14% |
| BACKLUND & ASSOCIATES PC3 Filed as: BACKLUND AND ASSOCIATES, PC | UNKNOWN MEDFORD, OR 97501 | PACIFICSOURCE HEALTH PLANS | $6K | $0 | $6K | 0.06% |
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 | 1,098 | 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) | 1,098 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PACIFICSOURCE HEALTH PLANS | 1,007 | $8.9M |
| Dental | PACIFICSOURCE HEALTH PLANS | 1,007 | $8.9M |
| Prescription drug | PACIFICSOURCE HEALTH PLANS | 1,007 | $8.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,007 | — |
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.