| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| J.L. JONES AND ASSOCIATES3 | 700 COUNTRY CLUB ROAD EUGENE, OR 97401 | PROVIDENCE HEALTH PLAN | $48K | $0 | $48K | 3.00% |
| UNKNOWN3 | UNKNOWN EUGENE, OR 97402 | OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON | $5K | $0 | $5K | 5.42% |
| MARY ESTHER TAYLOR3 | PO BOX 70334 SPRINGFIELD, OR 97475 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $330 | $2K | 3.99% |
| KERR-CRUICKSHANK, INC.3 Filed as: KERR-CRUICKSHANK INC. | 11740 SW 68TH PARKWAY PORTLAND, OR 97223 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 3.85% |
| EDWARD RICHARD ESTRADA3 | 580 PATRICK LOOP COTTAGE GROVE, OR 97424 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $340 | $1K | $1K | 2.92% |
| KATIE BURBERY3 | 2300 NORKENZIE ROAD EUGENE, OR 97401 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $975 | $198 | $1K | 2.54% |
| MJ INSURANCE3 Filed as: DAMON RAY OGIER AND VARIOUS AGENTS | 1630 CARNAHAN DRIVE, APARTMENT 5 GRANTS PASS, OR 97527 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $112 | $1K | 2.48% |
| SUSAN ELLEN WARD3 | 1501 SW JORDAN STREET GRANTS PASS, OR 97526 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $427 | $0 | $427 | 0.92% |
| THOMAS TAYLOR3 Filed as: THOMAS MCKY TAYLOR | PO BOX 70334 SPRINGFIELD, OR 97475 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $288 | $101 | $389 | 0.84% |
| J.L. JONES AND ASSOCIATES3 | 720 COUNTRY CLUB ROAD EUGENE, OR 97401 | VISION SERVICE PLAN | $884 | $0 | $884 | 6.42% |
| J.L. JONES AND ASSOCIATES3 | 720 COUNTRY CLUB ROAD EUGENE, OR 97401 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $555 | $0 | $555 | 10.00% |
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 | 175 | 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) | 175 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PROVIDENCE HEALTH PLAN | 173 | $1.6M |
| Dental | OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON | 207 | $101K |
| Vision(2 contracts, 2 carriers) | PROVIDENCE HEALTH PLAN | 173 | $1.6M |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 164 | $52K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 52 | $46K |
| Prescription drug | PROVIDENCE HEALTH PLAN | 173 | $1.6M |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 164 | $52K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 207 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.