| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| J.L. JONES AND ASSOCIATES3 Filed as: J L JONES AND ASSOCIATES | 720 COUNTRY CLUB ROAD, SUITE 100 EUGENE, OR 97401 | PACIFICSOURCE HEALTH PLANS | $57K | $0 | $57K | 3.81% |
| J L JONES3 | 720 COUNTRY CLUB ROAD EUGENE, OR 97401 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | $0 | $3K | 5.58% |
| J.L. JONES AND ASSOCIATES3 Filed as: J L JONES AND ASSOCIATES | 720 COUNTRY CLUB ROAD EUGENE, OR 97401 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | $0 | $3K | 13.57% |
| J L JONES3 | 720 COUNTRY CLUB ROAD EUGENE, OR 97401 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $246 | $0 | $246 | 1.85% |
| SVEND NILSSON3 | 92736 TRIANGLE LAKE RESORT ROAD BLACHLY, OR 97412 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $215 | $0 | $215 | 1.61% |
| MICHAEL S. MOLLOY3 Filed as: MICHAEL S MOLLOY | 1463 CAMP BAKER ROAD PHOENIX, OR 97535 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $144 | $0 | $144 | 1.08% |
| PREMIER WORKSITET SOLUTIONS3 | 112 NW 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $74 | $1 | $75 | 0.56% |
| KATHERINE NEVILLE AND MISC AGENTS3 | 708 CARDLEY AVENUE MEDFORD, OR 97504 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $51 | $1 | $52 | 0.39% |
| ZINE OSTER3 | 3153 FOREST DRIVE CHEYENNE, WY 82001 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $42 | $0 | $42 | 0.32% |
| ROXANA BUSCHMAN3 | 400 NE 149TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $35 | $0 | $35 | 0.26% |
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 | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 123 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | PACIFICSOURCE HEALTH PLANS | 246 | $1.5M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 250 | $52K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 138 | $24K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 138 | $24K |
| Prescription drug(2 contracts, 2 carriers) | PACIFICSOURCE HEALTH PLANS | 246 | $1.5M |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 138 | $24K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 250 | — |
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.