| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT WEEKS3 | K.P.D. INSURANCE LLC 10260 SW GREENBURG ROAD, SUITE 550 PORTLAND, OR 97223 | PROVIDENCE HEALTH PLAN | $17K | $0 | $17K | 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 | $0 | $3K | 4.54% |
| PACIFIC ADVISORS LLC3 Filed as: PACIFIC ADVISORS, LLC | UNKNOWN EUGENE, OR 97402 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $59 | $0 | $59 | 0.09% |
| K.P.D. INSURANCE, LLC3 | 1111 GATEWAY LOOP, PO BOX 29 SPRINGFIELD, OR 97477 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | $0 | $5K | 11.96% |
| IMA, INC.3 Filed as: PARKER SMITH & FEEK/IMA COMPANY | 2233 112TH AVENUE NE BELLEVUE, WA 98004 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $205 | $205 | 0.50% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE, LLC | PO BOX 784 SPRINGFIELD, OR 97477 | WILLAMETTE DENTAL INSURANCE, INC. | $619 | $0 | $619 | 5.00% |
| K.P.D. INSURANCE, LLC3 | PO BOX 784 SPRINGFIELD, OR 97477 | VISION SERVICE PLAN | $829 | — | $829 | 6.78% |
| RICHARD E. SYFERT3 Filed as: RICHARD E SYFERT | PO BOX 917 PLEASANT HILL, OR 97455 | AFLAC | $204 | $0 | $204 | 4.44% |
| BRADLEY R. SWANK3 Filed as: BRADLEY R SWANK | P O BOX 872 SPRINGFIELD, OR 97477 | AFLAC | $204 | $0 | $204 | 4.44% |
| JEROMY E. CILLEY3 Filed as: JEROMY E CILLEY | 2683 EAST WILSHIRE DRIVE EUGENE, OR 97405 | AFLAC | $67 | $0 | $67 | 1.46% |
| CHRISTINE L BREWSTER3 | 701 CEDAR STREET MCKINNEY, TX 75069 | AFLAC | $8 | $0 | $8 | 0.17% |
| GARY W WARE JR3 | 3103 MEADOWBROOK DRIVE CHAMPAIGN, IL 61822 | AFLAC | $1 | $0 | $1 | 0.02% |
| LORI WARE3 | 5611 THOME LOOP THE VILLAGES, FL 32163 | AFLAC | $0 | $0 | $0 | 0.00% |
| ADRIENNE SHOEMAKER3 Filed as: ADRIENNE L SHOEMAKER | 1501 EAST GRAND AVENUE SAINT JOSEPH, IL 61873 | AFLAC | $0 | $0 | $0 | 0.00% |
| MARGARET BRYANT3 | 18014 BELMORE AVENUE LAKE OSWEGO, OR 97035 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $166 | $7 | $173 | 4.12% |
| K.P.D. INSURANCE, LLC3 | 1111 GATEWAY LOOP SPRINGFIELD, OR 97477 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $115 | $0 | $115 | 2.74% |
| WORKSITES BENEFITS GROUP INC3 | 112 NW 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $41 | $14 | $55 | 1.31% |
| ISAACSON INSURANCE AGENCY LLC3 Filed as: ISAACSON INSURANCE AGENCY, LLC | 1250 11TH STREET WEST LINN, OR 97068 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $38 | $0 | $38 | 0.90% |
| MARY ESTHER TAYLOR3 | 3670 WESTWARD HO AVENUE EUGENE, OR 97401 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $32 | $0 | $32 | 0.76% |
| KAREN CLAY KUNKLER3 Filed as: KAREN CLAY JUNKLER | 415 SE 177TH AVENUE UNIT 236 VANCOUVER, WA 98683 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $23 | $0 | $23 | 0.55% |
| THOMAS TAYLOR3 Filed as: THOMAS MCKY TAYLOR | 3670 WESTWARD HO AVENUE EUGENE, OR 97401 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2 | $0 | $2 | 0.05% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE, LLC | PO BOX 784 SPRINGFIELD, OR 97477 | MASA | $77 | $0 | $77 | 5.45% |
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 | 109 | $854K |
| Dental(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 67 | $77K |
| Vision | VISION SERVICE PLAN | 62 | $12K |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 125 | $45K |
| Short-term disability(2 contracts, 2 carriers) | AFLAC | 5 | $9K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 125 | $41K |
| Prescription drug | PROVIDENCE HEALTH PLAN | 109 | $852K |
| Other(4 contracts, 4 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 125 | $54K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 125 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.