| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| J.L. JONES AND ASSOCIATES3 | 720 COUNTRY CLUB ROAD, SUITE 100 EUGENE, OR 97401 | PACIFICSOURCE HEALTH PLANS | $49K | $0 | $49K | 3.49% |
| J.L. JONES AND ASSOCIATES3 | 720 COUNTRY CLUB ROAD EUGENE, OR 97401 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | $0 | $3K | 5.54% |
| J.L. JONES AND ASSOCIATES3 | 720 COUNTRY CLUB ROAD EUGENE, OR 97401 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | $0 | $3K | 13.57% |
| J.L. JONES AND ASSOCIATES3 | 720 COUNTRY CLUB ROAD EUGENE, OR 97401 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $162 | $0 | $162 | 1.76% |
| SVEND NILSSON3 | 92736 TRIANGLE LAKE RESORT ROAD BLACHLY, OR 97412 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $130 | $0 | $130 | 1.42% |
| WORKSITE BENEFITS GROUP INC3 Filed as: WORKSITE BENEFITS GROUP | 112 NW 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $45 | $0 | $45 | 0.49% |
| ZINA OSTER3 | 3153 FOREST DRIVE CHEYENNE, WY 82001 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $25 | $0 | $25 | 0.27% |
| ROXANNA BUSCHMAN3 | 400 NE 149TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $25 | $0 | $25 | 0.27% |
| BENEFITS BY DESIGN INC3 Filed as: BENEFITS BY DESIGN AND OTHER AGENTS | 2101 NE 279TH STREET RIDGEFIELD, WA 98642 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $10 | $0 | $10 | 0.11% |
| RITA J ROBINSON3 Filed as: RITA J. ROBINSON | PO BOX 34 WEST LINN, OR 97068 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $7 | $0 | $7 | 0.08% |
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 | 116 | 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) | 117 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | PACIFICSOURCE HEALTH PLANS | 221 | $1.4M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 225 | $49K |
| 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 | 221 | $1.4M |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 138 | $24K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 225 | — |
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.