| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| OREGON DENTAL SERVICE5 Filed as: OREGON DENTAL SERVICE DBA DELTA DEN | PO BOX 40384 PORTLAND, OR 97240 | MODA, INC. | $0 | $669K | $669K | 11.86% |
| NORTHWESTERN MUTUAL3 | 465 COMMERCIAL ST NE STE 100 SALEM, OR 97301 | MODA, INC. | $12K | — | $12K | 0.21% |
| OREGON DENTAL SERVICE5 Filed as: OREGON DENTAL SERVICE DBA DELTA | PO BOX 40384 PORTLAND, OH 97240 | MODA, INC. | $0 | $44K | $44K | 14.10% |
| STRATEGIC EMPLOYEE BENEFIT SERVICES3 | 200 SW MARKET STREET PORTLAND, OR 97201 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18K | — | $18K | 10.42% |
| HEARTSEASE LLC3 | 1521 NE 63RD AVE HILLSBORO, OR 97124 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $3K | $7K | 3.81% |
| PREMIER WORKSITE SOLUTIONS INC3 Filed as: PREMIER WORKSITE SOLUTION INC | 112 NW 114TH ST VANCOUVER, WA 98685 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $2K | $4K | 2.52% |
| KAREN CLAY KUNKLER3 | 1709 NW 45TH AVENUE CAMAS, WA 98607 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $518 | $4K | 2.26% |
| BENEFITS BY DESIGN INC3 | 2101 NE 279TH ST RIDGEFIELD, WA 98642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $474 | $2K | 1.43% |
| CHRISTINE LYNN MORGESTER3 | 988 SW 26TH ST TROUTDALE, OR 98671 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $978 | — | $978 | 0.57% |
| MATTHEW SCOTT BENJAMIN3 | 698 12TH ST SE SALEM, OR 97301 | NORTHWESTERN MUTUAL | $12K | $3K | $15K | 14.78% |
| CAM GROUP LLC3 | 200 SW MARKET ST SUITE 1600 PORTLAND, OR 97201 | NORTHWESTERN MUTUAL | $3K | $322 | $3K | 2.88% |
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 | 305 | 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) | 305 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MODA, INC. | 320 | $5.6M |
| Dental | MODA, INC. | 317 | $314K |
| Life insurance | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 305 | $173K |
| Long-term disability | NORTHWESTERN MUTUAL | 278 | $104K |
| Prescription drug | MODA, INC. | 320 | $5.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 320 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.