| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE | PO BOX 29 SPRINGFIELD, OR 97477 | PROVIDENCE HEALTH PLAN | $23K | $0 | $23K | 2.01% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE | PO BOX 784 SPRINGFIELD, OR 97477 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $3K | $0 | $3K | 4.95% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE | PO BOX 29 SPRINGFIELD, OR 97477 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | $0 | $6K | 11.29% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE | PO BOX 29 SPRINGFIELD, OR 97477 | WILLAMETTE DENTAL INSURANCE, INC. | $1K | $0 | $1K | 5.00% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE | PO BOX 784 SPRINGFIELD, OR 97477 | VISION SERVICE PLAN | $973 | $0 | $973 | 5.98% |
| RICHARD E. SYFERT3 Filed as: RICHARD E. SEYFERT | 86195 PANORAMA ROAD SPRINGFIELD, OR 97478 | AFLAC | $204 | $0 | $204 | 3.12% |
| BRADLEY R. SWANK3 | PO BOX 872 SPRINGFIELD, OR 97477 | AFLAC | $204 | $0 | $204 | 3.12% |
| JEROMY E. CILLEY3 | 1115 PEARL STREET EUGENE, OR 97401 | AFLAC | $67 | $0 | $67 | 1.02% |
| MARY POHLMAN3 | 27735 214TH AVENUE SE MAPLE VALLEY, WA 98038 | AFLAC | $48 | $16 | $64 | 0.98% |
| MJ INSURANCE3 Filed as: RICHARD SUMMERS AND VARIOUS AGENTS | 450 COUNTRY CLUB ROAD, SUITE 330 EUGENE, OR 97401 | AFLAC | $43 | $5 | $48 | 0.73% |
| PACIFIC BENEFIT CONSULTANTS3 | 450 COUNTRY CLUB ROAD, SUITE 330 EUGENE, OR 97401 | AFLAC | $39 | $0 | $39 | 0.60% |
| CHARLES H WEISSBERGER3 Filed as: CHARLES H. WEISSBERGER | 5128 CREEKMONTE DRIVE ROCHESTER, MI 48306 | AFLAC | $23 | $4 | $27 | 0.41% |
| MARGARET BRYANT3 | 18014 SW BELMORE AVENUE LAKE OSWEGO, OR 97035 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $252 | $38 | $290 | 4.80% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE | PO BOX 29 SPRINGFIELD, OR 97477 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $208 | $0 | $208 | 3.44% |
| ISAACSON INSURANCE AGENCY LLC3 | 1250 11TH STREET WEST LINN, OR 97068 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $149 | $21 | $170 | 2.81% |
| PREMIER WORKSITE SOLUTIONS INC3 | 112 NW 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $78 | $36 | $114 | 1.89% |
| KAREN CLAY KUNKLER3 | 1709 NW 45TH AVENUE CAMAS, WA 98607 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $58 | $7 | $65 | 1.08% |
| MARY ESTHER TAYLOR3 | PO BOX 70334 SPRINGFIELD, OR 97475 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $48 | $0 | $48 | 0.79% |
| MJ INSURANCE3 Filed as: THOMAS TAYLOR AND VARIOUS AGENTS | PO BOX 70334 SPRINGFIELD, OR 97475 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5 | $0 | $5 | 0.08% |
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 | 164 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 164 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PROVIDENCE HEALTH PLAN | 176 | $1.2M |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 88 | $99K |
| Vision | VISION SERVICE PLAN | 82 | $16K |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 77 | $57K |
| Short-term disability(2 contracts, 2 carriers) | AFLAC | 7 | $13K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 77 | $51K |
| Prescription drug | PROVIDENCE HEALTH PLAN | 176 | $1.2M |
| Other(4 contracts, 4 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 164 | $69K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 176 | — |
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.