| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST | PO BOX 3018 BOTHELL, WA 98041 | PRINICPAL LIFE INSURANCE COMPANY | $13K | $0 | $13K | 9.05% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 150 NORTH RIVERSIDE PLAZA SUITE 1700 CHICAGO, IL 60606 | PRINICPAL LIFE INSURANCE COMPANY | $0 | $4K | $4K | 2.91% |
| MARCI MARIE OTIS3 | 200 JULINA LANE ROSEBURG, OR 97471 | CONTINENTAL AMERICAN INSURANCE COMPANY | $852 | $0 | $852 | 51.79% |
| CAROL ANN KENYON3 | 1641 CLEVELAND HILL ROAD ROSEBURG, OR 97470 | CONTINENTAL AMERICAN INSURANCE COMPANY | $629 | $0 | $629 | 38.24% |
| RICHARD E. SYFERT3 Filed as: RICHARD ERIC SYFERT | 86195 PANORAMA ROAD SPRINGFIELD, OR 97478 | CONTINENTAL AMERICAN INSURANCE COMPANY | $130 | $0 | $130 | 7.90% |
| SHAWN MICHAEL OTIS3 | 2350 OAKMONT WAY EUGENE, OR 97401 | CONTINENTAL AMERICAN INSURANCE COMPANY | $99 | $0 | $99 | 6.02% |
| MARK D LUTHER3 Filed as: MARK D. LUTHER | 804 MOORFIELD PARK DRIVE, SUITE 106 RICHMOND, VA 23236 | CONTINENTAL AMERICAN INSURANCE COMPANY | $96 | $0 | $96 | 5.84% |
| MJ INSURANCE3 Filed as: RAYMON P. KEECH AND VARIOUS AGENTS | 8207 CAMPAIGN CIRCLE RICHMOND, TX 77406 | CONTINENTAL AMERICAN INSURANCE COMPANY | $96 | $0 | $96 | 5.84% |
| JEROMY E. CILLEY3 | 2683 EAST WILSHIRE DRIVE EUGENE, OR 97405 | CONTINENTAL AMERICAN INSURANCE COMPANY | $79 | $0 | $79 | 4.80% |
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 | 268 | 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) | 268 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PACIFICSOURCE HEALTH PLANS | 380 | $2.7M |
| Dental(2 contracts, 2 carriers) | WILLAMETTE DENTAL INSURANCE, INC. | 207 | $174K |
| Vision | PACIFICSOURCE HEALTH PLANS | 380 | $2.7M |
| Life insurance | PRINICPAL LIFE INSURANCE COMPANY | 319 | $141K |
| Short-term disability | PRINICPAL LIFE INSURANCE COMPANY | 319 | $141K |
| Long-term disability | PRINICPAL LIFE INSURANCE COMPANY | 319 | $141K |
| Prescription drug | PACIFICSOURCE HEALTH PLANS | 380 | $2.7M |
| Other(4 contracts, 4 carriers) | PRINICPAL LIFE INSURANCE COMPANY | 319 | $243K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 380 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.