| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE LLC | 10260 SW GREENBURG ROAD, SUITE 550 PORTLAND, OR 97223 | PROVIDENCE HEALTH PLAN | $20K | $0 | $20K | 2.00% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE LLC | PO BOX 29 SPRINGFIELD, OR 97477 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | $450 | $3K | 5.23% |
| PACIFIC ADVISORS LLC3 | UNKNOWN EUGENE, OR 97402 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $220 | $0 | $220 | 0.34% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE INC | 1111 GATEWAY LOOP SPRINGFIELD, OR 97477 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | $0 | $5K | 11.47% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE INC | 1111 GATEWAY LOOP 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 | $1K | $0 | $1K | 7.76% |
| BRADLEY R. SWANK3 Filed as: BRADLEY SWANK | PO BOX 872 SPRINGFIELD, OR 97477 | AFLAC | $325 | $0 | $325 | 4.87% |
| RICHARD E. SYFERT3 Filed as: RICHARD SYFERT | PO BOX 917 PLEASANT HILL, OR 97455 | AFLAC | $235 | $0 | $235 | 3.52% |
| JEROMY E. CILLEY3 Filed as: JEROMY CILLEY | 2683 EAST WILSHIRE DRIVE EUGENE, OR 97405 | AFLAC | $67 | $0 | $67 | 1.00% |
| CORINNA MARIE GOLUBICS3 Filed as: CORINNA GOLUBICS | 2940 CRESCENT AVENUE, UNIT 261 EUGENE, OR 97408 | AFLAC | $30 | $0 | $30 | 0.45% |
| PACIFIC BENEFIT CONSULTANTS3 | 450 COUNTRY CLUB ROAD, SUITE 330 EUGENE, OR 97401 | AFLAC | $10 | $0 | $10 | 0.15% |
| CHRISTINE L BREWSTER3 Filed as: CHRISTINE BREWSTER | 1312 FARLEY LANE CHAMPAIGN, IL 61822 | AFLAC | $8 | $0 | $8 | 0.12% |
| MJ INSURANCE3 Filed as: RICHARD SUMMERS AND VARIOUS AGENTS | 450 COUNTRY CLUB ROAD, SUITE 330 EUGENE, OR 97401 | AFLAC | $8 | $0 | $8 | 0.12% |
| MARGARET BRYANT3 | 18014 SW BELMORE AVENUE LAKE OSWEGO, OR 97035 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $569 | $194 | $763 | 12.74% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE INC | 1111 GATEWAY LOOP SPRINGFIELD, OR 97477 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $332 | $0 | $332 | 5.54% |
| WORKSITE BENEFITS GROUP INC3 | 112 NW 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $128 | $166 | $294 | 4.91% |
| MJ INSURANCE3 Filed as: KAREN KUNKLER | 415 SE 177TH AVENUE, UNIT 236 VANCOUVER, WA 98683 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $187 | $16 | $203 | 3.39% |
| ISAACSON INSURANCE AGENCY LLC3 | 1250 11TH STREET WEST LINN, OR 97068 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $61 | $0 | $61 | 1.02% |
| MARY TAYLOR3 | 3670 WESTWARD HO AVENUE EUGENE, OR 97401 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $34 | $0 | $34 | 0.57% |
| THOMAS TAYLOR3 | 3670 WESTWARD HO AVENUE EUGENE, OR 97401 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2 | $0 | $2 | 0.03% |
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 | 125 | 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) | 125 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | PROVIDENCE HEALTH PLAN | 126 | $981K |
| Dental(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 60 | $87K |
| Vision | VISION SERVICE PLAN | 68 | $13K |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 97 | $49K |
| Short-term disability(2 contracts, 2 carriers) | AFLAC | 8 | $13K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 97 | $43K |
| Prescription drug | PROVIDENCE HEALTH PLAN | 126 | $981K |
| Other(4 contracts, 4 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 125 | $60K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 126 | — |
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.