| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RICK JOHN HAGAN HAMILTON INSURANCE3 Filed as: RICK JOHN OF HAGAN HAMILTON INS. | 448 SE BAKER ST. MCMINNVILLE, OR 97128 | MEDICAL PROVIDENCE HEALTH | $39K | $0 | $39K | 2.78% |
| MJ INSURANCE3 Filed as: HAGAN HAMILTON - MJI, INC. | P.O. BOX 847 MCMINNVILLE, OR 97128 | LIFEMAP ASSURANCE COMPANY | $8K | $0 | $8K | 11.58% |
| MJ INSURANCE3 Filed as: MJI, INC DBA HAGAN HAMILTON INSURAN | P.O. BOX 847 MCMINNVILLE, OR 97128 | VSP - VISION SERVICE PLAN | $1K | $0 | $1K | 5.86% |
| THOMAS AND MARY ESTHER TAYLOR3 | 1126 GATEWAY LOOP SPRINGFIELD, OR 97477 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $755 | $99 | $854 | 5.35% |
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 | 164 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 54 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 218 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICAL PROVIDENCE HEALTH | 234 | $1.4M |
| Vision | VSP - VISION SERVICE PLAN | 111 | $17K |
| Life insurance | LIFEMAP ASSURANCE COMPANY | 157 | $72K |
| Short-term disability(2 contracts, 2 carriers) | LIFEMAP ASSURANCE COMPANY | 157 | $88K |
| Long-term disability | LIFEMAP ASSURANCE COMPANY | 157 | $72K |
| Other | LIFEMAP ASSURANCE COMPANY | 157 | $72K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 234 | — |
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.