| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| UNKNOWN3 | UNKNOWN EUGNE, OR 97440 | OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON | $20K | $0 | $20K | 3.00% |
| J.L. JONES AND ASSOCIATES3 | 720 COUNTRY CLUB ROAD EUENE, OR 97401 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $17K | $0 | $17K | 10.37% |
| MJ INSURANCE3 Filed as: JAMES SARANTIS AND VARIOUS AGENTS | 2281 LAVA RIDGE COURT, SUITE 130 ROSEBURG, OR 95661 | AFLAC | $7K | $136 | $7K | 5.76% |
| MARCI MARIE OTIS3 Filed as: MARCI OTIS | 200 JULINA LANE ROSEBURG, OR 97471 | AFLAC | $3K | $220 | $4K | 2.91% |
| CAROL A. KENYON3 Filed as: CAROL KENYON | 1645 CLEVELAND HILL ROAD ROSEBURG, OR 97471 | AFLAC | $3K | $162 | $3K | 2.52% |
| REUEL S DAVIS3 Filed as: REUEL DAVIS | 9460 WEST FAIRVIEW AVENUE SUITE 140 BOISE, ID 83704 | AFLAC | $1K | $378 | $2K | 1.41% |
| HILLARY EYRE3 | 9460 WEST FAIRVIEW AVENUE SUITE 125 BOISE, ID 83704 | AFLAC | $554 | $123 | $677 | 0.53% |
| RALPH DOW3 | 2552 SW 35TH COURT REDMOND, OR 97756 | AFLAC | $472 | $0 | $472 | 0.37% |
| GARY LOWE3 | 13106 NANTUCKET PLACE BAKERSFIELD, CA 93314 | AFLAC | $336 | $0 | $336 | 0.26% |
| JEFF JONES3 | 720 COUNTRY CLUB ROAD EUGENE, OR 97401 | VISION SERVICE PLAN | $3K | $0 | $3K | 2.46% |
| SVEND NILSSON3 | 1220 JACOBS DRIVE EUGENE, OR 97402 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $128 | $0 | $128 | 1.95% |
| THOMAS TAYLOR3 Filed as: THOMAS MCKY TAYLOR | PO BOX 70334 SPRINGFIELD, OR 97475 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | $0 | $11 | 0.17% |
| PREMIER WORKSITE SOLUTIONS INC3 Filed as: PREMIER WORKSITE SOLUTIONS INC. | 112 NW 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | $0 | $8 | 0.12% |
| ZINA OSTER3 | 3153 FOREST DRIVE CHEYENNE, WY 82001 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | $0 | $8 | 0.12% |
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 | 1,195 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,203 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON | 1,617 | $792K |
| Vision(2 contracts, 2 carriers) | AFLAC | 910 | $239K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,781 | $174K |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,781 | $301K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,781 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.