| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| J.B. NIBLEY INS.3 Filed as: J.B. NIBLEY INSURANCE | 18080 SW 1ST, 10 PORTLAND, OR 97201 | PROVIDENCE HEALTH PLAN | $76K | — | $76K | 0.30% |
| JOSEPH H. HERRLE & ASSOCIATES3 | 1800 SW 1ST, 280 PORTLAND, OR 97201 | PROVIDENCE HEALTH PLAN | $76K | — | $76K | 0.30% |
| JOSEPH H. HERRLE & ASSOCIATES3 Filed as: JOSEPH HERRLE & ASSOCIATES | 1800 SW 1ST, 280 PORTLAND, OR 97201 | KAISER PERMANENTE NW REGION | $66K | — | $66K | 0.44% |
| J.B. NIBLEY INS.3 | 1800 SW 1ST, 10 PORTLAND, OR 97201 | KAISER PERMANENTE NW REGION | $66K | — | $66K | 0.44% |
| J.B. NIBLEY INS.3 | 1800 SW 1ST, 10 PORTLAND, OR 97201 | REGENCE BLUE CROSS/BLUE SHIELD OF OREGON | $111K | — | $111K | 3.73% |
| J.H. HERRLE & ASSOCIATES3 Filed as: J.H. HERRLE & ASS. | 1800 SW 1ST, 280 PORTLAND, OR 97201 | REGENCE BLUE CROSS/BLUE SHIELD OF OREGON | $111K | — | $111K | 3.73% |
| J.B. NIBLEY INS.3 Filed as: NIBLEY & HERRLE ASS. | 1800 SW 1ST, 280 PORTLAND, OR 97201 | SYMETRA LIFE INSURANCE COMPANY | — | — | $0 | 0.00% |
| JOSEPH H. HERRLE & ASSOCIATES3 | 1800 SW 1ST, 280 PORTLAND, OR 97201 | PROVIDENCE HEALTH PLAN | — | — | $0 | 0.00% |
| J.B. NIBLEY INS.3 Filed as: J.B. NIBLEY INSURANCE | 1800 SW 1ST, 10 PORTLAND, OR 97201 | PROVIDENCE HEALTH PLAN | — | — | $0 | 0.00% |
| J.B. NIBLEY INS. | 1800 SW 1ST, 10 PORTLAND, OR 972015321 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 0.55% |
| J.H. HERRLE & ASSOCIATES Filed as: J.H. HERRLE & ASSOC. | 1800 SW 1ST, 10 PORTLAND, OR 972015321 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 0.55% |
| J.B. NIBLEY INS.3 Filed as: J.B. NIBLEY INSURANCE INC, | 1800 SW 1ST AVE, STE. 10 PORTLAND, OR 97201 | ASURIS NORTHWEST HEALTH | $248 | — | $248 | 0.11% |
| J.H. HERRLE & ASSOCIATES3 | 1800 SW 1ST AVE, STE. 280 PORTLAND, OR 97201 | ASURIS NORTHWEST HEALTH | $248 | — | $248 | 0.11% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENESYS, INC. EIN 38-2383171 THIRD PARTY ADMINISTRATOR | Contract Administrator Service code 13 | 1220 SW MORRISON, 300 PORTLAND, OR 97204 | $2.7M |
| FERGUSON & WELLMAN EIN 93-0646986 INVESTMENT MANAGER | Investment management Service code 28 | 888 SW FIFTH AVENUE 1200 PORTLAND, OR 97204 | $702K |
| CANOPY / CASCADE CENTERS EIN 93-0774210 EAP | Employee (plan) Service code 30 | 7180 SW FIR LOOP, SUITE 1 PORTLAND, OR 97223 | $234K |
| WELLS FARGO COMMUNITY BANKING EIN 94-1347393 BANKING SERVICES | Account maintenance fees Service code 65 | 1300 SW 5TH AVENUE PORTLAND, OR 97201 | $147K |
| TELEDOC HEALTH EIN 04-3705970 HEALTHCARE APP | Other services Service code 49 | 2 MANHATTANVILLE RD. PURCHASE, NY 10577 | $76K |
| WELLS FARGO BANK EIN 94-2984230 INVESTMENT CUSTODIAN | Custodial (securities) Service code 19 | 1300 SW 5TH AVENUE PORTLAND, OR 97201 | $61K |
| MILLIMAN USA EIN 91-0675641 ACTUARY | Actuarial Service code 11 | 111 SW 5TH AVENUE, 2900 PORTLAND, OR 97204 | $49K |
| OREGON-COLUMBIA NECA EIN 93-0336168 THIRD PARTY ADMINISTRATOR | Contract Administrator Service code 13 | 601 NE EVERETT PORTLAND, OR 97232 | $47K |
| BJORKLUND & MONTPLAISIR EIN 93-1015766 AUDITOR | Accounting (including auditing) Service code 10 | 9020 SW WASHINGTON SQU RD PORTLAND, OR 97223 | $36K |
| BROWNSTEIN RASK LLP EIN 93-0589000 LEGAL COUNSEL | Legal Service code 29 | 1200 SW MAIN ST. PORTLAND, OR 97205 | $32K |
| CORELLIAN SOFTWARE, INC. EIN 47-1372895 RECORDKEEPER | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | 5331 SW MACADAM, 258 PORTLAND, OR 97239 | $29K |
| THORP, PURDY, JEWETT, ET AL EIN 93-0770706 COLLECTION ATTORNEY | Legal Service code 29 | 1011 HARLOW ROAD, ST. 300 SPRINGFIELD, OR 97477 | $26K |
| J.B. NIBLEY INSURANCE, INC. EIN 93-0494041 PLAN CONSULTANT | Consulting (general) Service code 16 | 1800 SW FIRST AVE., 10 PORTLAND, OR 97201 | $17K |
| JOSEPH H. HERRLE & ASSOCIATES, INC. EIN 93-0692196 PLAN CONSULTANT | Consulting (general) Service code 16 | 1800 SW FIRST AVE., 1800 PORTLAND, OR 97201 | $17K |
| BENNETT, HARTMAN, MORRIS, & KAPLAN EIN 93-0633539 COLLECTION ATTORNEY | Legal Service code 29 | 111 SW 5TH AVENUE, 1650 PORTLAND, OR 97204 | $12K |
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 | 7,847 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,865 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 9,712 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | PROVIDENCE HEALTH PLAN | 4,454 | $30.1M |
| Dental | WILLAMETTE DENTAL INSURANCE, INC. | 4,488 | $2.0M |
| Vision(2 contracts, 2 carriers) | REGENCE BLUE CROSS/BLUE SHIELD OF OREGON | 15,136 | $3.7M |
| Life insurance | STANDARD INSURANCE COMPANY | 6,915 | $279K |
| Prescription drug(2 contracts, 2 carriers) | REGENCE BLUE CROSS/BLUE SHIELD OF OREGON | 963 | $3.2M |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 5,908 | $2.5M |
| Other(2 contracts, 2 carriers) | REGENCE BLUE CROSS/BLUE SHIELD OF OREGON | 6,915 | $3.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 15,136 | — |
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.