| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF OREGON LLC | PO BOX 29018 PORTLAND, OR 97296 | PACIFICSOURCE HEALTH PLANS | $12K | — | $12K | 1.12% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVENUE, SUITE 200 WALNUT CREEK, CA 94596 | PACIFICSOURCE HEALTH PLANS | $8K | — | $8K | 0.76% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF OREGON LLC | PO BOX 29018 PORTLAND, OR 97296 | STANDARD INSURANCE COMPANY | $5K | — | $5K | 4.56% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVENUE, SUITE 200 WALNUT CREEK, CA 94596 | STANDARD INSURANCE COMPANY | $739 | — | $739 | 0.71% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF OREGON LLC | PO BOX 29018 PORTLAND, OR 97296 | UNUM LIFE INSURANCE COMPANY | $3K | $193 | $3K | 6.90% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVENUE, SUITE 200 WALNUT CREEK, CA 94596 | UNUM LIFE INSURANCE COMPANY | $2K | — | $2K | 4.19% |
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 | 107 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 109 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PACIFICSOURCE HEALTH PLANS | 109 | $1.0M |
| Dental | STANDARD INSURANCE COMPANY | 111 | $104K |
| Vision | PACIFICSOURCE HEALTH PLANS | 109 | $1.0M |
| Life insurance | UNUM LIFE INSURANCE COMPANY | 115 | $50K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY | 115 | $50K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY | 115 | $50K |
| Prescription drug | PACIFICSOURCE HEALTH PLANS | 109 | $1.0M |
| Other | UNUM LIFE INSURANCE COMPANY | 115 | $50K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 115 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.