| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE PARTNERS GROUP3 | 11740 SW 68TH PARKWAY PORTLAND, OR 97223 | AETNA LIFE INSURANCE COMPANY | $0 | -$24K | -$24K | -0.91% |
| IMA, INC.3 | 430 EAST DOUGLAS, SUITE 400 WICHITA, KS 67202 | HARTFORD LIFE AND ACCIDENT | $0 | $1K | $1K | 2.03% |
| IMA, INC.3 Filed as: PARKER SMITH & FEEK, AN IMA COMPANY | 2233 112TH AVENUE NE BELLEVUE, WA 98004 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $311 | $311 | 0.62% |
| CAROL A. KENYON3 Filed as: CAROL A KENYON | 1645 CLEVELAND HILL ROAD ROSEBURG, OR 97471 | AFLAC | $799 | $6 | $805 | 5.85% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE, LLC | PO BOX 29 SPRINGFIELD, OR 97477 | AFLAC | $309 | $0 | $309 | 2.24% |
| MARCI MARIE OTIS3 | 200 JULINA LANE ROSEBURG, OR 97471 | AFLAC | $206 | $6 | $212 | 1.54% |
| VINCENT BRIAN VOLLMAR3 | 4085 HAGER STREET SE, SUITE 300 SALEM, OR 97317 | AFLAC | $103 | $3 | $106 | 0.77% |
| RICHARD E. SYFERT3 Filed as: RICHARD E SYFERT | PO BOX 917 PLEASANT HILL, OR 97455 | AFLAC | $49 | $3 | $52 | 0.38% |
| RUSSELL JENSEN3 | 2452 NW HUMMINGBIRD DRIVE CORVALLIS, OR 97330 | AFLAC | $50 | $0 | $50 | 0.36% |
| MJ INSURANCE3 Filed as: JOHN T JEWELL & VARIOUS AGENTS | 2428 AULDRIDGE DRIVE CHRISTIANA, TN 37037 | AFLAC | $24 | $0 | $24 | 0.17% |
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 | 263 | 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) | 263 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 408 | $2.6M |
| Dental(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 408 | $2.7M |
| Vision | VISION SERVICE PLAN | 214 | $30K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 263 | $62K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 257 | $50K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 257 | $50K |
| Prescription drug | AETNA LIFE INSURANCE COMPANY | 408 | $2.6M |
| Other(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 263 | $125K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 408 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.