| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE INC | PO BOX 29 SPRINGFIELD, OR 97477 | PROVIDENCE HEALTH PLAN | $23K | $0 | $23K | 2.01% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE INC | PO BOX 784 SPRINGFIELD, OR 97477 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $4K | $324 | $4K | 5.39% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE INC | 1111 GATEWAY LOOP SPRINGFIELD, OR 97477 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | $0 | $6K | 11.26% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE INC | PO BOX 29 SPRINGFIELD, OR 97477 | WILLAMETTE DENTAL INSURANCE, INC. | $1K | $0 | $1K | 5.00% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE INC | PO BOX 784 SPRINGFIELD, OR 97477 | VISION SERVICE PLAN | $953 | $0 | $953 | 6.06% |
| BRADLEY R. SWANK3 | PO BOX 872 SPRINGFIELD, OR 97477 | AFLAC | $874 | $0 | $874 | 10.58% |
| RICHARD E. SYFERT3 | PO BOX 917 PLEASANT HILL, OR 97455 | AFLAC | $301 | $0 | $301 | 3.64% |
| CORINNA MARIE GOLUBICS3 | 2940 CRESCENT AVENUE, UNIT 261 EUGENE, OR 97408 | AFLAC | $146 | $0 | $146 | 1.77% |
| MJ INSURANCE3 Filed as: STEVEN POHLMAN AND VARIOUS AGENTS | 27735 2214TH AVENUE SE MAPLE VALLEY, WA 98038 | AFLAC | $77 | $0 | $77 | 0.93% |
| JEROMY E. CILLEY3 | 2683 EAST WILSHIRE DRIVE EUGENE, OR 97405 | AFLAC | $67 | $0 | $67 | 0.81% |
| MARY POHLMAN3 | 27735 214TH AVENUE SE MAPLE VALLEY, WA 98038 | AFLAC | $41 | $0 | $41 | 0.50% |
| PACIFIC BENEFIT CONSULTANTS3 | 450 COUNTRY CLUB ROAD, SUITE 330 EUGENE, OR 97401 | AFLAC | $39 | $0 | $39 | 0.47% |
| MARGARET BRYANT3 | 18014 SW BELMORE AVENUE LAKE OSWEGO, OR 97035 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $255 | $37 | $292 | 5.75% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE INC | 1111 GATEWAY LOOP SPRINGFIELD, OR 97477 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $206 | $0 | $206 | 4.05% |
| KAREN CLAY KUNKLER3 | 1709 NW 45TH AVENUE CAMAS, WA 98607 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $145 | $53 | $198 | 3.90% |
| WORKSITE BENEFITS GROUP INC3 | 112 NW 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $52 | $47 | $99 | 1.95% |
| ISAACSON INSURANCE AGENCY LLC3 | 1250 11TH STREET WEST LINN, OR 97068 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $62 | $0 | $62 | 1.22% |
| MARY TAYLOR3 Filed as: MARY ESTHER TAYLOR AND OTHER AGENTS | PO BOX 70334 SPRINGFIELD, OR 97475 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $42 | $0 | $42 | 0.83% |
| PREMIER WORKSITE SOLUTIONS INC3 | 112 NW 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $24 | $16 | $40 | 0.79% |
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 | 133 | 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) | 133 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | PROVIDENCE HEALTH PLAN | 169 | $1.1M |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 77 | $103K |
| Vision | VISION SERVICE PLAN | 82 | $16K |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 75 | $54K |
| Short-term disability(2 contracts, 2 carriers) | AFLAC | 6 | $13K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 75 | $49K |
| Prescription drug | PROVIDENCE HEALTH PLAN | 169 | $1.1M |
| Other(4 contracts, 4 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 133 | $68K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 169 | — |
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.