| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOSEPH H. HERRLE & ASSOCIATES | 1800 SW 1ST, 280 PORTLAND, OR 97201 | PROVIDENCE HEALTH PLAN | $42K | — | $42K | 0.30% |
| J.B. NIBLEY INS. Filed as: J.B. NIBLEY INSURANCE | 18080 SW 1ST, 10 PORTLAND, OR 97201 | PROVIDENCE HEALTH PLAN | $42K | — | $42K | 0.30% |
| JOSEPH H. HERRLE & ASSOCIATES Filed as: JOSEPH HERRLE & ASSOCIATES | 1800 SW 1ST, 280 PORTLAND, OR 97201 | KAISER PERMANENTE NW REGION | $48K | — | $48K | 0.47% |
| J.B. NIBLEY INS. | 1800 SW 1ST, 10 PORTLAND, OR 97201 | KAISER PERMANENTE NW REGION | $48K | — | $48K | 0.47% |
| J.B. NIBLEY INS.3 | 1800 SW 1ST, 10 PORTLAND, OR 97201 | REGENCE BLUE CROSS/BLUE SHIELD OF OREGON | $92K | — | $92K | 3.96% |
| J.H. HERRLE & ASSOCIATES3 Filed as: J.H. HERRLE & ASS. | 1800 SW 1ST, 280 PORTLAND, OR 97201 | REGENCE BLUE CROSS/BLUE SHIELD OF OREGON | $92K | — | $92K | 3.96% |
| JOSEPH H. HERRLE & ASSOCIATES | 1800 SW 1ST, 280 PORTLAND, OR 97201 | PROVIDENCE HEALTH PLAN | — | — | $0 | 0.00% |
| J.B. NIBLEY INS. Filed as: J.B. NIBLEY INSURANCE | 1800 SW 1ST, 10 PORTLAND, OR 97201 | PROVIDENCE HEALTH PLAN | — | — | $0 | 0.00% |
| J.B. NIBLEY INS. Filed as: NIBLEY & HERRLE ASS. | 1800 SW 1ST, 280 PORTLAND, OR 97201 | SYMETRA LIFE INSURANCE COMPANY | — | — | $0 | 0.00% |
| J.B. NIBLEY INS.3 Filed as: J.B. NIBLEY INSURANCE INC, | 1800 SW 1ST AVE, STE. 10 PORTLAND, OR 97201 | ASURIS NORTHWEST HEALTH | $5K | — | $5K | 2.51% |
| J.H. HERRLE & ASSOCIATES3 | 1800 SW 1ST AVE, STE. 280 PORTLAND, OR 97201 | ASURIS NORTHWEST HEALTH | $5K | — | $5K | 2.51% |
| J.B. NIBLEY INS. | 1800 SW 1ST, 10 PORTLAND, OR 972015321 | STANDARD INSURANCE COMPANY | $1K | — | $1K | 0.79% |
| J.H. HERRLE & ASSOCIATES | 1800 SW 1ST, 280 PORTLAND, OR 972015321 | STANDARD INSURANCE COMPANY | $1K | — | $1K | 0.79% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENESYS, INC. EIN 38-2383171 NONE | Contract Administrator Service code 13 | 1220 SW MORRISON, 300 PORTLAND, OR 97204 | $1.8M |
| FERGUSON & WELLMAN EIN 93-0646986 NONE | Investment management Service code 28 | 888 SW FIFTH AVENUE 1200 PORTLAND, OR 97204 | $393K |
| WELLS FARGO COMMUNITY BANKING EIN 94-1347393 NONE | Account maintenance fees Service code 65 | 1300 SW 5TH AVENUE PORTLAND, OR 97201 | $82K |
| OREGON-COLUMBIA NECA EIN 93-0336168 NONE | Plan Administrator Service code 14 | 601 NE EVERETT PORTLAND, OR 97232 | $43K |
| WELLS FARGO BANK EIN 94-2984230 NONE | Custodial (securities) Service code 19 | 1300 SW 5TH AVENUE PORTLAND, OR 97201 | $41K |
| BROWNSTEIN RASK LLP EIN 93-0589000 NONE | Legal Service code 29 | 1200 SW MAIN ST. PORTLAND, OR 97205 | $40K |
| MILLIMAN USA EIN 91-0675641 NONE | Actuarial Service code 11 | 111 SW 5TH AVENUE, 2900 PORTLAND, OR 97204 | $37K |
| THORP, PURDY, JEWETT, ET AL EIN 93-0770706 NONE | Legal Service code 29 | 1011 HARLOW ROAD, ST. 300 SPRINGFIELD, OR 97477 | $37K |
| BJORKLUND & MONTPLAISIR EIN 93-1015766 NONE | Accounting (including auditing) Service code 10 | 9020 SW WASHINGTON SQU RD PORTLAND, OR 97223 | $34K |
| CORELLIAN SOFTWARE, INC. EIN 47-1372895 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | 5331 SW MACADAM, 258 PORTLAND, OR 97239 | $27K |
| BENNETT, HARTMAN, MORRIS, & KAPLAN EIN 93-0633539 NONE | Legal Service code 29 | 111 SW 5TH AVENUE, 1650 PORTLAND, OR 97204 | $20K |
| J.B. NIBLEY INSURANCE, INC. EIN 93-0494041 NONE | Consulting (general) Service code 16 | 1800 SW FIRST AVE., 10 PORTLAND, OR 97201 | $17K |
| JOSEPH H. HERRLE & ASSOCIATES, INC. EIN 93-0692196 NONE | Consulting (general) Service code 16 | 1800 SW FIRST AVE., 1800 PORTLAND, OR 97201 | $17K |
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 | 4,754 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,836 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 6,590 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | PROVIDENCE HEALTH PLAN | 3,780 | $17.2M |
| Dental | WILLAMETTE DENTAL INSURANCE, INC. | 2,218 | $870K |
| Vision(2 contracts, 2 carriers) | REGENCE BLUE CROSS/BLUE SHIELD OF OREGON | 4,534 | $2.9M |
| Life insurance | STANDARD INSURANCE COMPANY | 4,889 | $152K |
| Prescription drug(2 contracts, 2 carriers) | REGENCE BLUE CROSS/BLUE SHIELD OF OREGON | 982 | $2.5M |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 237 | $384K |
| Other(2 contracts, 2 carriers) | REGENCE BLUE CROSS/BLUE SHIELD OF OREGON | 4,889 | $2.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,889 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.