| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MODA HEALTH5 Filed as: MODA INC. | PO BOX 40384 PORTLAND, OR 97240 | MODA, INC. | — | $510K | $510K | 7.81% |
| JEFFREY FALLICK3 | 200 SW MARKET ST SUITE 1600 PORTLAND, OR 97201 | MODA, INC. | $38K | — | $38K | 0.58% |
| PAUL SEEGERT3 | 200 SW MARKET ST SUITE 1600 PORTLAND, OR 97201 | MODA, INC. | $4K | — | $4K | 0.06% |
| OREGON DENTAL SERVICE5 | PO BOX 40384 PORTLAND, OR 97240 | MODA, INC. | $0 | $32K | $32K | 6.91% |
| MATTHEW SCOTT BENJAMIN3 Filed as: MATTHEW S BENJAMIN | 465 COMMERICAL ST NE STE 100 SALEM, OR 97301 | NORTHWESTERN MUTUAL | $16K | $4K | $20K | 13.41% |
| CAM GROUP LLC3 | 200 SW MARKET STREET STE 1600 PORTLAND, OR 97201 | NORTHWESTERN MUTUAL | $3K | $383 | $4K | 2.40% |
| MATTHEW SCOTT BENJAMIN3 | 465 COMMERCIAL STREET NE SUITE 100 SALEM, OR 97301 | NORTHWESTERN MUTUAL | $13K | $5K | $18K | 15.34% |
| CAM GROUP LLC3 | 200 SW MARKET ST SUITE 1600 PORTLAND, OR 97201 | NORTHWESTERN MUTUAL | $3K | $301 | $3K | 2.41% |
| SCOTT L REED3 | 345 NW 28TH ST REDMOND, OR 977565518 | PRINCIPAL LIFE INSURANCE COMPANY | $9K | — | $9K | 8.56% |
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 | 422 | 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) | 422 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MODA, INC. | 422 | $6.5M |
| Dental | MODA, INC. | 426 | $467K |
| Life insurance | NORTHWESTERN MUTUAL | 555 | $117K |
| Short-term disability(2 contracts, 2 carriers) | NORTHWESTERN MUTUAL | 503 | $254K |
| Long-term disability | NORTHWESTERN MUTUAL | 503 | $149K |
| Prescription drug | MODA, INC. | 422 | $6.5M |
| Other | PRINCIPAL LIFE INSURANCE COMPANY | 203 | $105K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 555 | — |
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.