| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE PARTNERS GROUP3 | 11850 SW 67TH AVE, STE 100 PORTLAND, OR 97223 | PROVIDENCE HEALTH PLAN | $73K | $0 | $73K | 3.09% |
| THE PARTNERS GROUP3 | 11850 SW 67TH AVE, STE 100 PORTLAND, OR 97223 | HARTFORD LIFE AND ACCIDENT | $27K | $2K | $29K | 16.18% |
| THE PARTNERS GROUP3 | 11850 SW 67TH AVE, STE 100 PORTLAND, OR 97223 | WILLAMETTE DENTAL INSURANCE, INC | $7K | $0 | $7K | 5.00% |
| THE PARTNERS GROUP3 | 11850 SW 67TH AVE, STE 100 PORTLAND, OR 97223 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $727 | $0 | $727 | 3.17% |
| NICHOLS, DALE, ALLEN3 | 728 LEGENDS CREST DRIVE FRANKLIN, TN 37069 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $81 | $0 | $81 | 0.35% |
| LEONARD ADAMS INSURANCE INC3 Filed as: LEONARD ADAMS INSURANCE | 5201 SW WESTGATE DR, STE 300 PORTLAND, OR 97221 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $36 | $0 | $36 | 0.16% |
| THE PARTNERS GROUP3 | 11850 SW 67TH AVE, STE 100 PORTLAND, OR 97223 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $921 | $32 | $953 | 17.87% |
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 | 368 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 13 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 384 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PROVIDENCE HEALTH PLAN | 299 | $2.4M |
| Dental | WILLAMETTE DENTAL INSURANCE, INC | 156 | $144K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 368 | $177K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 368 | $177K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 368 | $177K |
| Other(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 368 | $205K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 368 | — |
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.