| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| J.B. NIBLEY INS.3 Filed as: JB NIBLEY INSURANCE, INC. | 1800 SW FIRST AVE. #10 PORTLAND, OR 97201 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $13K | $460 | $13K | 2.07% |
| HUGGINS INSURANCE SERVICES, INC.3 Filed as: HUGGINS INSURANCE SERVICES INC | 235 FRONT STREET SE, SUITE 100 SALEM, OR 97301 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $1K | $26 | $1K | 0.18% |
| J.B. NIBLEY INS.3 Filed as: JB NIBLEY INSURANCE INC | 1800 SW 1ST AVE STE 10 PORTLAND, OR 97201 | LIFEMAP ASSURANCE COMPANY | $2K | — | $2K | 6.92% |
| NASBURG HUGGINS AGENCY3 | 375 S 4TH ST COOS BAY, OR 97420 | LIFEMAP ASSURANCE COMPANY | $251 | — | $251 | 1.00% |
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 | 110 | 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) | 110 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 110 | $635K |
| Life insurance | LIFEMAP ASSURANCE COMPANY | 116 | $25K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 110 | $635K |
| Other | LIFEMAP ASSURANCE COMPANY | 116 | $25K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 116 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.