| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 55 E JACKSON BLVD 14TH FL STE 14A CHICAGO, IL 60604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 3.23% |
| J.L. JONFES & ASSOCIATES INC3 | 720 COUNTRY CLUB RD STE 100 EUGENE, OR 97401 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 2.42% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 55 E JACKSON BLVD 14TH FL STE 14A CHICAGO, IL 60604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 7.92% |
| J.L. JONES AND ASSOCIATES3 Filed as: J.L. JONES & ASSOCIATES INC | 720 COUNTRY CLUB RD STE 100 EUGENE, OR 97401 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 4.55% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 55 E JACKSON BLVD 14TH FL STE 14A CHICAGO, IL 60604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 5.10% |
| J.L. JONES AND ASSOCIATES3 Filed as: J.L. JONES & ASSOCIATES INC | 720 COUNTRY CLUB RD STE 100 EUGENE, OR 97401 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $880 | — | $880 | 3.07% |
| J.L. JONES AND ASSOCIATES3 Filed as: J.L. JONES & ASSOCIATES INC | 720 COUNTRY CLUB RD STE 100 EUGENE, OR 97401 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $596 | — | $596 | 4.75% |
| J L JONES3 Filed as: J.L. JONES & SSOCIATES INC | 720 COUNTRY CLUB RD STE 100 EUGENE, OR 97401 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $518 | — | $518 | 5.91% |
| J.L. JONES AND ASSOCIATES3 Filed as: J.L. JONES & ASSOCIATES INC | 720 COUNTRY CLUB RD STE 100 EUGENE, OR 97401 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $515 | — | $515 | 6.18% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 55 E JACKSON BLVD 14TH FL STE 14A CHICAGO, IL 60604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $398 | — | $398 | 5.12% |
| J.L. JONES AND ASSOCIATES3 Filed as: J.L. JONES & ASSOCIATES INC | 720 COUNTRY CLUB RD STE 100 EUGENE, OR 97401 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $235 | — | $235 | 3.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| FIRST CHOICE HEALTH NETWORK, INC EIN 91-1272766 NONE | Claims processing; Contract Administrator Service code 12 | — | $146K |
| NAVITUS HEALTH SOLUTIONS EIN 04-3608530 NONE | Contract Administrator; Claims processing Service code 12 | — | $7K |
| RXBENEFITS EIN 63-1157085 NONE | Claims processing; Contract Administrator Service code 12 | — | $502 |
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 | 241 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 18 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 259 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 245 | $29K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 245 | $44K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 141 | $29K |
| Other(5 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 245 | $66K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 245 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.