| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON | $4K | $0 | $4K | 3.49% |
| CORRIE PERSING3 | PO BOX 663 MANZANITA, OR 97130 | AFLAC | $3K | $46 | $3K | 4.66% |
| MJ INSURANCE3 Filed as: WENDY DOWNING AND VARIOUS AGENTS | PO BOX 1041 TILLAMOOK, OR 97141 | AFLAC | $2K | $30 | $3K | 4.03% |
| JASON PERKINS3 Filed as: JASON PERKINS LLC | 1308 WEST SEASCAPE DRIVE GILBERT, AZ 85233 | AFLAC | $637 | $26 | $663 | 1.06% |
| RICK M MCKINNEY3 Filed as: RICK M. MCKINNEY | 300 RIVERWALK TERRACE, SUITE 260 JENKS, OK 74037 | AFLAC | $471 | $0 | $471 | 0.75% |
| DEBBIE HODGSON3 Filed as: DEBBIE L. HODGSON | 360 TUNNEL CREEK ROAD GRANTS PASS, OR 97526 | AFLAC | $372 | $0 | $372 | 0.59% |
| DAVID LOVELL REID3 | 4924 CEDAR STREET ASTORIA, OR 97103 | AFLAC | $361 | $0 | $361 | 0.58% |
| VIRGINIA L KNOPSKI3 Filed as: VIRGINIA L. KNOPSKI | 3900 NE 97TH AVENUE VANCOUVER, WA 98662 | AFLAC | $226 | $0 | $226 | 0.36% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | STANDARD INSURANCE COMPANY | $2K | $0 | $2K | 11.53% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | PRINCIPAL LIFE INSURANCE COMPANY | $821 | $0 | $821 | 8.06% |
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 | 113 | 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) | 113 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MODA HEALTH | 178 | $1.1M |
| Dental(2 contracts, 2 carriers) | OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON | 227 | $175K |
| Vision(3 contracts, 3 carriers) | AFLAC | 162 | $89K |
| Life insurance(3 contracts, 3 carriers) | AFLAC | 162 | $89K |
| Short-term disability | AFLAC | 69 | $63K |
| Prescription drug | MODA HEALTH | 178 | $1.1M |
| Other | AFLAC | 69 | $63K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 227 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.