| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX 2329 LAKE OSWEGO, OR 97035 | UNITEDHEALTHCARE INSURANCE COMPANY | $1K | $37K | $38K | 2.97% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | 6443 SW BEAVERTON HILLSDALE HIGHWAY SUITE 200 PORTLAND, OR 97221 | AFLAC | $3K | $0 | $3K | 6.85% |
| JOSEPH FOXLEY3 | 2660 RAINIER PLACE WEST LINN, OR 97068 | AFLAC | $1K | $54 | $1K | 3.25% |
| LARRY A MORRIS3 Filed as: LARRY MORRIS | 259 SOUTH SEQUOIA PARKWAY SUITE K093 CANBY, OR 97013 | AFLAC | $1K | $12 | $1K | 2.82% |
| STEPHANIE JOELAINE THOMAS ROID3 Filed as: STEPHANIE THOMAS ROID | 902 LOWER GARDEN VALLEY ROAD ROSEBURG, OR 97471 | AFLAC | $792 | $0 | $792 | 1.90% |
| DANIEL HOLCOMBE3 | 21603 SW CEDAR BROOK WAY APARTMENT 110 SHERWOOD, OR 97140 | AFLAC | $508 | $0 | $508 | 1.22% |
| TJ INSURANCE LLC3 | 31001 PERIWINKLE STREET FOREST GROVE, OR 97116 | AFLAC | $378 | $23 | $401 | 0.96% |
| CRTSTAL MCCARTHY3 | 2715 SW 31ST STREET GRESHAM, OR 97080 | AFLAC | $182 | $0 | $182 | 0.44% |
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 | 157 | 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) | 157 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 157 | $1.3M |
| Dental | OREGON DENTAL SERVICES DBA DELTA DENTAL PLAN OF OREGON | 172 | $71K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 157 | $1.3M |
| Life insurance | UNITEDHEALTHCARE INSURANCE COMPANY | 157 | $1.3M |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 157 | $1.3M |
| Other(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 157 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 172 | — |
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.