| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE INC. | PO BOX 784 SPRINGFIELD, OR 97477 | LIFEMAP ASSURANCE COMPANY | $4K | $0 | $4K | 10.40% |
| JOSEPH FIDDY INC3 Filed as: JOSEPH FIDDY INC. | 2000 WEST HARVARD AVENUE, SUITE 100 ROSEBURG, OR 97471 | AFLAC | $806 | $0 | $806 | 20.99% |
| RICHRD SYFERT3 | 86195 PANORAMA ROAD SPRINGFIELD, OR 97478 | AFLAC | $170 | $0 | $170 | 4.43% |
| JEROMY E. CILLEY3 Filed as: JEROMY CILLEY | 1115 PEARL STREET EUGENE, OR 97401 | AFLAC | $114 | $0 | $114 | 2.97% |
| MJ INSURANCE3 Filed as: MARY TAYLOR AND VARIOUS AGENTS | 3670 WESTWARD HO AVENUE EUGENE, OR 97401 | AFLAC | $58 | $0 | $58 | 1.51% |
| MARCI MARIE OTIS3 Filed as: MARCI OTIS | 200 JULINA LANE ROSEBURG, OR 97471 | AFLAC | $37 | $0 | $37 | 0.96% |
| ROSELLA FREEMAN3 | PO BOX 901 REDWOOD VALLEY, CA 95470 | AFLAC | $31 | $0 | $31 | 0.81% |
| CAROL A. KENYON3 Filed as: CAROL KENYON | 1645 CLEVELAND HILL ROAD ROSEBURG, OR 97471 | AFLAC | $26 | $0 | $26 | 0.68% |
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 | 134 | 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) | 134 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 134 | $0 |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 134 | $0 |
| Life insurance | LIFEMAP ASSURANCE COMPANY | 134 | $43K |
| Short-term disability | LIFEMAP ASSURANCE COMPANY | 134 | $43K |
| Other(2 contracts, 2 carriers) | LIFEMAP ASSURANCE COMPANY | 134 | $46K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 134 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.