| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JBL&K INSURANCE3 | PO BOX 29018 PORTLAND, OR 97296 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $11K | — | $11K | 0.75% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN NORTHWEST | PO BOX 29018 PORTLAND, OR 972969018 | VISION SERVICE PLAN | $17K | — | $17K | 3.00% |
| JBL&K INSURANCE3 | PO BOX 29018 PORTLAND, OR 97296 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 11.16% |
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 | 14,256 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 290 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 14,546 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | REGENCE BLUECROSS BLUESHIELD OF OREGON | 7,070 | $41.7M |
| Dental | REGENCE BLUECROSS BLUESHIELD OF OREGON | 7,070 | $41.7M |
| Vision | VISION SERVICE PLAN | 6,019 | $570K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 10,530 | $1.4M |
| Short-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 21,127 | $7.4M |
| Long-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 21,127 | $7.4M |
| Prescription drug | REGENCE BLUECROSS BLUESHIELD OF OREGON | 7,070 | $41.7M |
| Other(2 contracts, 2 carriers) | LIFEWORKS US INC. | 14,256 | $257K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 21,127 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.