| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAGAN HAMILTON INSURANCE3 Filed as: HAGAN HAMILTON INSURANCE SERVICES | PO BOX 847 MCMINNVILLE, OR 97128 | PROVIDENCE HEALTH PLAN | $30K | — | $30K | 2.50% |
| MJ INSURANCE3 Filed as: MJI INC | D/B/A/ HAGAN HAMILTON INS SRVS PO BOX 847 MCMINNVILLE, OR 971280847 | METROPOLITAN LIFE INSURANCE COMPANY | $14K | $130 | $14K | 9.86% |
| HAGAN HAMILTON INSURANCE3 Filed as: HAGAN HAMILTON INSURANCE SERVICES | PO BOX 847 MCMINNVILLE, OR 971280847 | WILLAMETTE DENTAL INSURANCE, INC. | $2K | $4K | $6K | 17.00% |
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 | 145 | 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) | 145 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PROVIDENCE HEALTH PLAN | 278 | $1.2M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 313 | $181K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 313 | $146K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 313 | $146K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 313 | $146K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 313 | $146K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 313 | $146K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 313 | — |
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.