| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TIMOTHY HENNESSY3 | PO BOX 1185 CORVALLIS, OR 973391185 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $48K | — | $48K | 2.50% |
| TIMOTHY HENNESSY3 | PO BOX 1185 CORVALLIS, OR 973391185 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $48K | — | $48K | 2.50% |
| TIMOTHY HENNESSY3 | PO BOX 1185 CORVALLIS, OR 973391185 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $41K | — | $41K | 2.50% |
| TIMOTHY HENNESSY3 | PO BOX 1185 CORVALLIS, OR 973391185 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $12K | — | $12K | 2.50% |
| TIMOTHY HENNESSY3 | 226 SW 7TH ST PO BOX 1185 CORVALLIS, OR 973391185 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $86K | $9K | $95K | 20.46% |
| TIMOTHY HENNESSY3 | PO BOX 1185 CORVALLIS, OR 973391185 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $11K | — | $11K | 2.50% |
| TIMOTHY HENNESSY3 | PO BOX 1185 CORVALLIS, OR 973391185 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $75K | $7K | $82K | 20.39% |
| TIMOTHY HENNESSY3 | PO BOX 1185 CORVALLIS, OR 973391185 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 2.50% |
| TIMOTHY HENNESSY3 | PO BOX 1185 CORVALLIS, OR 973391185 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5K | — | $5K | 4.15% |
| BENEFIT COMMUNICATIONS INC0 Filed as: BENEFIT COMMUNICATIONS INC. | 2977 SIDCO DR NASHVILLE, TN 37204 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $641 | — | $641 | 0.49% |
| CHRISTOPHER R MORRIS3 | 2977 SIDCO DR NASHVILLE, TN 37204 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $256 | — | $256 | 0.20% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS INC. | 897 12TH ST HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.00% |
| TIMOTHY HENNESSY3 | PO BOX 1185 CORVALLIS, OR 973391185 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 2.50% |
| TIMOTHY HENNESSY3 | PO BOX 1185 CORVALLIS, OR 973391185 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX 1378 CORVALLIS, OR 97339 | ACE AMERICAN INSURANCE COMPANY | $285 | — | $285 | 15.00% |
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 | 5,548 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 44 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 5,592 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | WILLAMETTE DENTAL INSURANCE CO. | 4,507 | $1.7M |
| Life insurance(3 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 6,048 | $2.2M |
| Short-term disability(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 3,229 | $2.4M |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 5,398 | $1.9M |
| Other(7 contracts, 4 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 6,048 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 6,048 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.