| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| IMA, INC.3 Filed as: IMA INC | 136 EAST SOUTH TEMPLE, SUITE 2300 SALT LAKE CITY, UT 84111 | HARTFORD LIFE AND ACCIDENT | $0 | $3K | $3K | 6.10% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE INC | PO BOX 29 SPRINGFIELD, OR 97477 | AFLAC | $680 | $0 | $680 | 4.59% |
| CAROL A. KENYON3 Filed as: CAROL KENYON | 1645 CLEVELAND HILL ROAD ROSEBURG, OR 97471 | AFLAC | $501 | $0 | $501 | 3.38% |
| MARIC OTIS3 | 200 JULINA LANE ROSEBURG, OR 97471 | AFLAC | $501 | $0 | $501 | 3.38% |
| RUSSELL JENSEN3 | 2452 NW HUMMINGBIRD DRIVE CORVALLIS, OR 97330 | AFLAC | $313 | $0 | $313 | 2.11% |
| MJ INSURANCE3 Filed as: BRADLEY SWANK AND VARIOUS AGENTS | PO BOX 872 SPRINGFIELD, OR 97477 | AFLAC | $192 | $0 | $192 | 1.30% |
| VINCENT BRIAN VOLLMAR3 Filed as: VINCENT VOLLMAR | 4085 HAGER STREET SE, SUITE 300 SALEM, OR 97317 | AFLAC | $179 | $0 | $179 | 1.21% |
| RICHARD E. SYFERT3 Filed as: RICHARD SEYFERT | PO BOX 917 PLEASANT HILL, OR 97455 | AFLAC | $94 | $0 | $94 | 0.63% |
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 | 222 | 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) | 222 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 402 | $2.3M |
| Dental(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 402 | $2.3M |
| Vision | VISION SERVICE PLAN | 202 | $26K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 222 | $56K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 183 | $62K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 183 | $62K |
| Prescription drug | AETNA LIFE INSURANCE COMPANY | 402 | $2.3M |
| Other(3 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 222 | $132K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 402 | — |
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.
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.