| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ANDREW N LUCCOCK3 | 19766 WILDWOOD DR WEST LINN, OR 97068 | AFLAC | $607 | $75 | $682 | 5.35% |
| TERRI PEASE3 | 567 SAGUARO PL BARBERTON, OH 44203 | AFLAC | $275 | $0 | $275 | 2.16% |
| DDI BENEFITS INC.3 Filed as: DDI BENEFITS | 2111 NE HALSEY ST PORTLAND, OR 97232 | AFLAC | $258 | $0 | $258 | 2.03% |
| BRIDGET RENEA TOWNSEND3 | 28317 SW PARIS AVE WILSONVILLE, OR 97070 | AFLAC | $101 | $15 | $116 | 0.91% |
| ANDREW N LUCCOCK3 | PO BOX 1965 WILSONVILLE, OR 97070 | AFLAC | $72 | $0 | $72 | 0.57% |
| GINA L GAXIOLA3 | 730 MANDEVILLA WAY CORONA, CA 92879 | AFLAC | $59 | $0 | $59 | 0.46% |
| SARAH L PAVLOVICH3 Filed as: SARAH PAVLOVICH | 2575 MEDINA RD SUITE 1 MEDINA, OH 44256 | AFLAC | $51 | $0 | $51 | 0.40% |
| ASHLEY GRASER3 Filed as: ASHLEY LOREN GRASER | 2575 MEDINA RD SUITE 1 MEDINA, OH 44256 | AFLAC | $34 | $0 | $34 | 0.27% |
| JULIE L WOLD3 | 7720 E MOONRIDGE LN ANAHEIM, CA 92808 | AFLAC | $32 | $0 | $32 | 0.25% |
| MARIE HELENA EVANS3 | 13004 NW MARINA WAY PORTLAND, OR 97231 | AFLAC | $30 | $0 | $30 | 0.24% |
| BRYAN G CORBIN LLC3 | 17 WESTRIDGE DR LAKE OSWEGO, OR 97034 | AFLAC | $30 | $0 | $30 | 0.24% |
| THOMAS A HOUSE3 Filed as: THOMAS A HOUSE JR | 100 ASHLEIGH DR BRUNSWICK, OH 44212 | AFLAC | $18 | $0 | $18 | 0.14% |
| PAUL LANGAS3 Filed as: PAUL JON LANGAS | 4025 NW 77TH AVE CAMAS, WA 98607 | AFLAC | $16 | $0 | $16 | 0.13% |
| JERRY OLIVER CREECH3 | 5915 SANTO DOMINGO CT NEW BERN, NC 28560 | AFLAC | $16 | $0 | $16 | 0.13% |
| DAWN T SUCHECKI3 | 225 S WATER ST WILMINGTON, NC 28401 | AFLAC | $15 | $0 | $15 | 0.12% |
| JOSEPH MANGANO3 | 6100 OAK TREE BLVD SUITE 200 INDEPENDENCE, OH 44131 | AFLAC | $11 | $0 | $11 | 0.09% |
| G SCOTT COOKE3 Filed as: SCOTT E NIELSEN | 718B W FOURTH PLAIN BLVD VANCOUVER, WA 98660 | AFLAC | $10 | $0 | $10 | 0.08% |
| BRYAN JORAMO3 | 2606 STRASBURG DR FOREST GROVE, OR 97116 | AFLAC | $10 | $0 | $10 | 0.08% |
| JACOB J MCINTOSH3 | 665 S WOODRUFF AVE SUITE 250 IDAHO FALLS, OR 83401 | AFLAC | $9 | $0 | $9 | 0.07% |
| THOMAS A HOUSE3 | 1114 LATTIMORE DR CLERMONT, FL 34711 | AFLAC | $8 | $0 | $8 | 0.06% |
| MICHAEL C WALKER3 Filed as: MICHAEL L ALLEY | 2189 SE 12TH AVE CANBY, OR 97013 | AFLAC | $7 | $0 | $7 | 0.05% |
| ZINA SHADRIN3 | PO BOX 1704 LAKE OSWEGO, OR 97035 | AFLAC | $6 | $0 | $6 | 0.05% |
| RITA J ROBINSON3 | PO BOX 34 WEST LINN, OR 97068 | AFLAC | $5 | $0 | $5 | 0.04% |
| AMANDA C LONG3 | 107 HIDDEN OAK DR MARS, PA 16046 | AFLAC | $5 | $0 | $5 | 0.04% |
| BRIAN L HUGGER3 | 10117 SE SUNNYSIDE RD SUITE F52 CLACKAMAS, OR 97015 | AFLAC | $4 | $0 | $4 | 0.03% |
| MICHAEL C WALKER3 Filed as: MICHAEL M STASTNY | 605 PORTLAND AVE UNIT 531 GLADSTONE, OR 97027 | AFLAC | $3 | $0 | $3 | 0.02% |
| CHRISTOPHER WALLACE HOFF3 | 22996 SW LODGEPOLE AVE TULATIN, OR 97062 | AFLAC | $3 | $0 | $3 | 0.02% |
| ERIC DANIEL WEILAND3 | 14511 SW CORNERSTONE LN SHERWOOD, OR 97140 | AFLAC | $2 | $0 | $2 | 0.02% |
| MATTHEW G BERGER3 Filed as: MATTHEW SHROYER | 1384 NE 70TH AVE PORTLAND, OR 97213 | AFLAC | $2 | $0 | $2 | 0.02% |
| HARE AND ASSOCIATES LLC3 | 6324 TARTON FIELDS LN MASON, OH 45040 | AFLAC | $2 | $0 | $2 | 0.02% |
| MAKOWSKI INS AGCY INC3 Filed as: MAKOWSKI INS AGENCY INC. | 9404 WOODCHIP LN BROADVIEW HTS, OH 44147 | AFLAC | $1 | $0 | $1 | 0.01% |
| ROBERTA DICKINSON3 Filed as: ROBERTA S DICKINSON | 16141 HOWE RD STRONGSVILLE, OH 44136 | AFLAC | $1 | $0 | $1 | 0.01% |
| OPPORTUNITY INC3 Filed as: OPPORTUNITY INC. | 9404 WOODCHIP LN BROADVIEW HEIGHTS, OH 44147 | AFLAC | $1 | $0 | $1 | 0.01% |
| CAMERON CARRILLO3 | 61503 ORION DR BEND, OH 97702 | AFLAC | $1 | $0 | $1 | 0.01% |
| JACK A SHADE3 | 690 TREE BEND CT WESTERVILLE, OH 43082 | AFLAC | $1 | $0 | $1 | 0.01% |
| CURTIS A. ALMQUIST4 | 1665 NW HIGHLAND DR CORVALLIS, OR 97330 | PRE-PAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $189 | $0 | $189 | 8.83% |
| HIPSTER ONCE LLC4 | 1665 NW HIGHLAND DR CORVALLIS, OR 97330 | PRE-PAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $68 | $0 | $68 | 3.18% |
| TERRI PEASE3 | 567 SAGUARO PL BARBERTON, OH 44203 | AFLAC | $138 | $16 | $154 | 9.03% |
| THOMAS A HOUSE3 Filed as: THOMAS A HOUSE JR | 100 ASHLEIGH DR BRUNSWICK, OH 44212 | AFLAC | $27 | $0 | $27 | 1.58% |
| AMANDA C LONG3 | 107 HIDDEN OAK DR MARS, PA 16046 | AFLAC | $18 | $3 | $21 | 1.23% |
| JOSEPH MANGANO3 | 6100 OAK TREE BLVD SUITE 200 INDEPENDENCE, OH 44131 | AFLAC | $15 | $0 | $15 | 0.88% |
| THOMAS A HOUSE3 | 1114 LATTIMORE DR CLERMONT, FL 34711 | AFLAC | $13 | $0 | $13 | 0.76% |
| ASHLEY GRASER3 | 2575 MEDINA RD SUITE 1 MEDINA, OH 44256 | AFLAC | $7 | $0 | $7 | 0.41% |
| HARE AND ASSOCIATES LLC3 Filed as: HARE AND ASSOCIATES | 6324 TARTON FIELDS LN MASON, OH 45040 | AFLAC | $3 | $0 | $3 | 0.18% |
| MAKOWSKI INS AGCY INC3 Filed as: MAKOWSKI INS AGCY | 9404 WOODCHIP LN BROADVIEW HEIGHTS, OH 44147 | AFLAC | $2 | $0 | $2 | 0.12% |
| ROBERTA DICKINSON3 Filed as: ROBERTA S DICKINSON | 16141 HOWE RD STRONGVILLE, OH 44136 | AFLAC | $2 | $0 | $2 | 0.12% |
| OPPORTUNITY INC3 Filed as: OPPORTUNITY INC. | 9404 WOODCHIP LN BROADVIEW HEIGHTS, OH 44147 | AFLAC | $2 | $0 | $2 | 0.12% |
| JACK A SHADE3 | 690 TREE BEND CT WESTERVILLE, OH 43082 | AFLAC | $1 | $0 | $1 | 0.06% |
| DALE ALLEN NICHOLS3 | 728 LEGENDS CREST DRIVE FRANKLIN, TN 37069 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $77 | $0 | $77 | 6.97% |
| LEONARD ADAMS INSURANCE INC3 Filed as: LEONARD ADAMS INSURANCE INC. | 5201 SW WESTGATE DR. SUITE 300 PORTLAND, OR 37069 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $33 | $0 | $33 | 2.99% |
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 | 112 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 114 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PROVIDENCE HEALTH PLAN | 215 | $1.3M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 484 | $88K |
| Vision | PROVIDENCE HEALTH PLAN | 215 | $1.3M |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 112 | $77K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 112 | $77K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 112 | $77K |
| Prescription drug | PROVIDENCE HEALTH PLAN | 215 | $1.3M |
| Other(6 contracts, 5 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 114 | $98K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 484 | — |
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 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.