| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOHNSON BENEFIT GROUP, INC.3 | 21550 WILLAMETTE DRIVE WEST LINN, OR 97068 | PACIFICSOURCE HEALTH PLANS | $35K | — | $35K | 1.94% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN LLC | 2701 NW VAUGHN ST STE 340 PORTLAND, OR 97296 | PACIFICSOURCE HEALTH PLANS | $18K | — | $18K | 1.03% |
| JOHNSON BENEFIT GROUP, INC.3 | 21550 WILLAMETTE DRIVE WEST LINN, OR 97068 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 3.78% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN BROWN OF OREGON LLC | 2701 NW VAUGHN ST STE 340 PORTLAND, OR 97210 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 2.33% |
| JOHNSON BENEFIT GROUP, INC.3 | 21550 WILLAMETTE DRIVE WEST LINN, OR 97068 | WILLAMETTE DENTAL GROUP | $3K | — | $3K | 3.53% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN&BROWN | 2701 NW VAUGHN STREET, #340 PORTLAND, OR 97210 | WILLAMETTE DENTAL GROUP | $2K | — | $2K | 2.91% |
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 | 270 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 271 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | PACIFICSOURCE HEALTH PLANS | 270 | $2.0M |
| Dental(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 270 | $301K |
| Vision | PACIFICSOURCE HEALTH PLANS | 264 | $1.8M |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 270 | $220K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 270 | $220K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 270 | $220K |
| Prescription drug | PACIFICSOURCE HEALTH PLANS | 264 | $1.8M |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 270 | $220K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 270 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.