| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE, INC. | PO BOX 784 SPRINGFIELD, OR 97477 | REGENCE BLUECROSS BLUESHIELD OF OREGON | $25K | $1K | $26K | 4.38% |
| UNKNOWN3 | UNKNOWN WHITE CITY, OR 97503 | OREGON DENTAL SERVICES DBA DELTA DENTAL PLAN OF OREGON | $2K | $0 | $2K | 4.71% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE, INC. | PO BOX 784 SPRINGFIELD, OR 97477 | LIFEMAP ASSURANCE COMPANY | $3K | $0 | $3K | 9.10% |
| DEBBIE HODGSON3 Filed as: DEBBIE L. HOGSDON | 360 TUNNEL CREEK ROAD GRANTS PASS, OR 97526 | AFLAC | $2K | $220 | $2K | 9.34% |
| NOAH BAILEY3 | 201 WEST MAIN STREET, SUITE 4A MEDFORD, OR 97501 | AFLAC | $530 | $44 | $574 | 2.25% |
| MJ INSURANCE3 Filed as: LARRY K. GRIFFIN AND VARIOUS AGENTS | 2333 DERRY COURT MEDFORD, OR 97504 | AFLAC | $444 | $0 | $444 | 1.74% |
| KEEFE BURCHER3 Filed as: KEEFE P. BURCHER | 201 WEST MAIN STREET, SUITE 4A MEDFORD, OR 97501 | AFLAC | $339 | $44 | $383 | 1.50% |
| THOMAS EWING3 Filed as: THOMAS F. EWING | PO BOX 8802 MEDFORD, OR 97501 | AFLAC | $71 | $0 | $71 | 0.28% |
| JEFFREY STEPHEN FOGELQUIST3 | 769 NW MORGAN LANE GRANTS PASS, OR 97526 | AFLAC | $66 | $0 | $66 | 0.26% |
| CRYSTAL STILES3 | PO BOX 1434 PHOENIX, OR 97535 | AFLAC | $63 | $0 | $63 | 0.25% |
| DEBBIE HODGSON3 Filed as: DEBBIE L. HOGSDON | 360 TUNNEL CREEK ROAD GRANTS PASS, OR 97526 | AFLAC | $369 | $25 | $394 | 14.68% |
| NOAH BAILEY3 | 201 WEST MAIN STREET, SUITE 4A MEDFORD, OR 97501 | AFLAC | $115 | $5 | $120 | 4.47% |
| KEEFE BURCHER3 Filed as: KEEFE P. BURCHER | 201 WEST MAIN STREET, SUITE 4A MEDFORD, OR 97501 | AFLAC | $66 | $5 | $71 | 2.65% |
| FORREST LEAL3 | PO BOX 185 LIMA, MT 59739 | AFLAC | $21 | $0 | $21 | 0.78% |
| BONNIE J. LEWIS3 | PO BOX 95632 LAS VEGAS, NV 89193 | AFLAC | $13 | $0 | $13 | 0.48% |
| MJ INSURANCE3 Filed as: ROGER L. OLSON AND VARIOUS AGENTS | 471 DAVIS LAKE ROAD USK, WA 99180 | AFLAC | $13 | $0 | $13 | 0.48% |
| MADGE LEAL3 | PO BOX 185 LIMA, MT 59739 | AFLAC | $9 | $0 | $9 | 0.34% |
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 | 76 | 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) | 76 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | REGENCE BLUECROSS BLUESHIELD OF OREGON | 111 | $596K |
| Dental(2 contracts, 2 carriers) | OREGON DENTAL SERVICES DBA DELTA DENTAL PLAN OF OREGON | 76 | $76K |
| Vision | LIFEMAP ASSURANCE COMPANY | 147 | $30K |
| Life insurance | LIFEMAP ASSURANCE COMPANY | 147 | $30K |
| Short-term disability(2 contracts) | AFLAC | 23 | $28K |
| Prescription drug | REGENCE BLUECROSS BLUESHIELD OF OREGON | 111 | $596K |
| Other(2 contracts) | AFLAC | 23 | $28K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 147 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.