| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WEIS & ASSOCIATES3 Filed as: WEIS & ASSOCIATES INC | PO BOX 158 STAYTON, OR 97383 | MODA HEALTH | $24K | — | $24K | 3.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NW LLC | 12100 NE 195TH SUITE 200 BOTHELL, WA 98011 | UNITED OF OMAHA LIFE INSURANCE | $4K | — | $4K | 8.28% |
| WEIS & ASSOCIATES3 | 448 N 2ND AVE STAYTON, OR 97383 | UNITED OF OMAHA LIFE INSURANCE | $935 | — | $935 | 1.72% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NW LLC | 12100 NE 195TH BOTHELL, WA 98011 | UNITED OF OMAHA LIFE INSURANCE | $3K | — | $3K | 12.69% |
| WEIS & ASSOCIATES0 | 448 N 2ND AVE STAYTON, OR 97383 | UNITED OF OMAHA LIFE INSURANCE | $472 | — | $472 | 2.32% |
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 | 168 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 168 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MODA HEALTH | 168 | $807K |
| Dental | UNITED OF OMAHA LIFE INSURANCE | 102 | $54K |
| Vision | UNITED OF OMAHA LIFE INSURANCE | 81 | $8K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE | 78 | $20K |
| Other | UNITED OF OMAHA LIFE INSURANCE | 78 | $20K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 168 | — |
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.