| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MJ INSURANCE3 Filed as: MJI, INC. DBA HAGAN HAMILTON INS. | PO BOX 847 MCMINNVILLE, OR 97218 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $31K | $1K | $32K | 1.84% |
| MJ INSURANCE3 Filed as: MJI INC DBA HAGAN HAMILTON INS | PO BOX 847 MCMINNVILLE, OR 97128 | PRINCIPAL LIFE INSURANCE COMPANY | $21K | $8K | $28K | 10.94% |
| MJ INSURANCE3 Filed as: MJI, INC DBA HAGAN HAMILTON INSURAN | PO BOX 847 MCMINNVILLE, OR 97128 | VISION SERVICE PLAN | $2K | — | $2K | 3.70% |
| SHEREEN EMDE3 | 6449 HIGHWAY 219 NORTHEAST GERVAIS, OR 97026 | AFLAC | $2K | $54 | $2K | 10.42% |
| TREVOR WILKS3 | 722 HIGHLAND AVENUE NORTHEAST SALEM, OR 97301 | AFLAC | $268 | — | $268 | 1.63% |
| VINCENT BRIAN VOLLMAR3 Filed as: VINCENT VOLLMAR | 3295 TRIANGLE DRIVE SOUTHEAST SUITE 120 SALEM, OR 97302 | AFLAC | $195 | — | $195 | 1.18% |
| PAUL FRAMPTON3 | 3616 GRAND OAK DRIVE NEWBERG, OR 97132 | AFLAC | $186 | — | $186 | 1.13% |
| MELISSA HOLLENBECK3 | 493 WEST FIR STREET STAYTON, OR 97383 | AFLAC | $131 | — | $131 | 0.79% |
| ALICIA J MATSON3 Filed as: ALICIA MATSON | 6027 ROLLETTI DRIVE SOUTHEAST SALEM, OR 97306 | AFLAC | $120 | $11 | $131 | 0.79% |
| SHARON DOUGLASS3 | 702 PATROL STREET MOLALLA, OR 97038 | AFLAC | $116 | — | $116 | 0.70% |
| WILLIAM R MEDITZ3 Filed as: WILLIAM MEDITZ | PO BOX 20475 KEIZER, OR 97307 | AFLAC | $81 | — | $81 | 0.49% |
| BRAD P CHEWNING3 Filed as: BRAD CHEWNING | 26000 HALL ROAD WILLAMINA, OR 97396 | AFLAC | $77 | — | $77 | 0.47% |
| JOSHUA ANDERSON3 | 1341 NORTH 16TH STREET MONMOUTH, OR 97361 | AFLAC | $59 | $11 | $70 | 0.42% |
| KENNETH MAGEE3 | 3760 MARKET STREET NORTHEAST 347 SALEM, OR 97301 | AFLAC | $67 | — | $67 | 0.41% |
| NICHOLAS JENSEN3 | 4965 SOUTHWEST SAUM WAY TUALATIN, OR 97062 | AFLAC | $60 | — | $60 | 0.36% |
| SCOTT NIELSEN3 | 1089 LAKE WASHINGTON BOULEVARD NORT APARTMENT 306 RENTON, WA 98056 | AFLAC | $47 | — | $47 | 0.29% |
| MJ INSURANCE3 Filed as: MJI INC DBA HAGAN | PO BOX 847 MCMINNVILLE, OR 97128 | AFLAC | $37 | — | $37 | 0.22% |
| SHANE HUNTER3 | 708 BROWNING AVENUE SOUTH APARTMENT 14 SALEM, OR 97302 | AFLAC | $29 | — | $29 | 0.18% |
| LARRI B WHEELER3 | 81640 LOST VALLEY LANE DEXTER, OR 97431 | AFLAC | $29 | — | $29 | 0.18% |
| ORVILLE DELKER3 | 3001 SUNNY HILL CIRCLE RAPID CITY, SD 57702 | AFLAC | $27 | — | $27 | 0.16% |
| PAUL HANNANT3 | 7180 SOUTHWEST FIR LOOP SUITE 250 TIGARD, OR 97223 | AFLAC | $22 | — | $22 | 0.13% |
| TERRIE RUNOLFSON3 | PO BOX 1959 COTTONWOOD, CA 96022 | AFLAC | $18 | — | $18 | 0.11% |
| JEFFORY MERTEN3 | 906 NORTHWEST LEWISBURG AVENUE CORVALLIS, OR 97330 | AFLAC | $15 | — | $15 | 0.09% |
| ROBERT ALLEN WHEELER3 Filed as: ROBERT WHEELER | 645 NORTHWEST EVE DRIVE DALLAS, OR 97338 | AFLAC | $13 | — | $13 | 0.08% |
| MARCI MARIE OTIS3 Filed as: MARCI OTIS | 200 JULINA LANE ROSEBURG, OR 97471 | AFLAC | $8 | — | $8 | 0.05% |
| BRET L RUNOLFSON3 Filed as: BRET RUNOLFSON | 450 PEARSON ROAD PARADISE, CA 95969 | AFLAC | $7 | — | $7 | 0.04% |
| NOLA EVANS INC3 Filed as: NOLA EVANS | 10853 SOUTH RIDGE TOP DRIVE CANBY, OR 97013 | AFLAC | $7 | — | $7 | 0.04% |
| ARDELL SMITH3 | 4334 NORTHWEST CHANTICLEAR DRIVE APARTMENT N-5 PORTLAND, OR 97229 | AFLAC | $6 | — | $6 | 0.04% |
| IOANNIS T GRATSINOPOULOS3 Filed as: IOANNIS GRATSINOPOULOS | 3565 SUMMERLINN DRIVE WEST LINN, OR 97068 | AFLAC | $5 | — | $5 | 0.03% |
| ERNEST E SNOOK3 Filed as: ERNEST SNOOK | 14011 282ND LANE NORTHEAST DUVALL, WA 98019 | AFLAC | $5 | — | $5 | 0.03% |
| BARRY T FISHER3 | 4055 PIEDMONT LAKE ROAD PINE MOUNTAIN, GA 31822 | AFLAC | $5 | — | $5 | 0.03% |
| GINA SIENIA3 | 8710 SOUTHWEST ASH MEADOWS ROAD APARTMENT 1137 WILSONVILLE, OR 97070 | AFLAC | $4 | — | $4 | 0.02% |
| ERIC DANIEL WEILAND3 Filed as: ERIC WEILAND | 14511 SOUTHWEST CORNERSTONE LANE SHERWOOD, OR 97140 | AFLAC | $3 | — | $3 | 0.02% |
| SHANE EDMUND ATTEBERY3 Filed as: SHANE ATTEBERY | 1260 NORTH DUTTON AVENUE SUITE 180 SANTA ROSA, CA 95401 | AFLAC | $3 | — | $3 | 0.02% |
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 | 431 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 437 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 321 | $1.7M |
| Vision | VISION SERVICE PLAN | 433 | $45K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 432 | $259K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 432 | $259K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 432 | $259K |
| Other(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 432 | $276K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 433 | — |
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."
No prospect flags tripped on this filing.