| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WARD INSURANCE AGENCY INC3 | PO BOX 10167 EUGENE, OR 97440 | REGENCE BLUECROSS BLUESHIELD OF OREGON | $14K | $3K | $17K | 1.70% |
| PROPEL INSURANCE AGENCY LLC3 | PO BOX 2940 TACOMA, WA 98401 | REGENCE BLUECROSS BLUESHIELD OF OREGON | $8K | $0 | $8K | 0.82% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INERNATIONAL NW LLC | 12100 NE 195TH STREET, SUITE 200 BOTHELL, WA 98041 | REGENCE BLUECROSS BLUESHIELD OF OREGON | $8K | $0 | $8K | 0.80% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INERNATIONAL NW LLC | 12100 NE 195TH STREET, SUITE 200 BOTHELL, WA 98041 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $6K | $0 | $6K | 7.16% |
| WARD INSURANCE AGENCY INC3 | PO BOX 10167 EUGENE, OR 97440 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $5K | $0 | $5K | 6.07% |
| PROPEL INSURANCE3 | 888 SW 5TH AVENUE, SUITE 1170 PORTLAND, OR 97204 | WILLAMETTE DENTAL INSURANCE, INC | $2K | $0 | $2K | 5.00% |
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 | 122 | 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) | 122 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | REGENCE BLUECROSS BLUESHIELD OF OREGON | 120 | $1.0M |
| Dental(2 contracts, 2 carriers) | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 119 | $140K |
| Vision | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 119 | $90K |
| Life insurance | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 119 | $90K |
| Long-term disability | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 119 | $90K |
| Prescription drug | REGENCE BLUECROSS BLUESHIELD OF OREGON | 120 | $1.0M |
| Other(2 contracts, 2 carriers) | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 122 | $93K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 122 | — |
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.