| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ANDREW N LUCCOCK3 | 23984 SOUTHWEST SHADY GROVE DRIVE SHERWOOD, OR 97140 | AFLAC | $758 | — | $758 | 8.76% |
| DDI BENEFITS INC.3 Filed as: DDI BENEFITS | 2111 NORTHEAST HALSEY STREET PORTLAND, OR 97232 | AFLAC | $357 | — | $357 | 4.12% |
| TYLER JACOB JORAMO3 | 3101 PERIWINKLE STREET FORST GROVE, OR 97116 | AFLAC | $87 | — | $87 | 1.01% |
| BRIDGET RENEA TOWNSEND3 | 28317 SOUTHWEST PARIS AVENUE WILSONVILLE, OR 97070 | AFLAC | $29 | — | $29 | 0.34% |
| JOSEPH MANGANO3 | 6100 OAK TREE BOULEVARD SUITE 200 INDEPENDENCE, OK 44131 | AFLAC | $18 | — | $18 | 0.21% |
| JERRY OLIVER CREECH3 | 5915 SANTO DOMINGO COURT NEW BERN, NC 28560 | AFLAC | $17 | — | $17 | 0.20% |
| G SCOTT COOKE3 Filed as: SCOTT E NIELSEN | 718B WEST FOURTH PLAIN BOULEVARD VANCOUVER, WA 98660 | AFLAC | $11 | — | $11 | 0.13% |
| BRYAN JORAMO3 | 2606 STRASBURG DRIVE FOREST GROVE, OR 97116 | AFLAC | $10 | — | $10 | 0.12% |
| JACOB J MCINTOSH3 | 665 SOUTH WOODRUFF AVENUE SUITE 250 IDAHO FALLS, OR 83401 | AFLAC | $10 | — | $10 | 0.12% |
| AMANDA C LONG3 | 150 NORTH MEADOWS DRIVE WEXFORD, PA 15090 | AFLAC | $9 | — | $9 | 0.10% |
| ZINA SHADRIN3 | PO BOX 1704 LAKE OSWEGO, OR 97035 | AFLAC | $6 | — | $6 | 0.07% |
| RITA J ROBINSON3 Filed as: RITA JANE ROBINSON | 30256 SOUTHWEST THOMAS STREET UNIT 1106 WILSONVILLE, OR 97070 | AFLAC | $5 | — | $5 | 0.06% |
| THOMAS A HOUSE3 Filed as: THOMAS A HOUSE JR | 100 ASHLEIGH DRIVE BRUNSWICK, OH 44212 | AFLAC | $5 | — | $5 | 0.06% |
| TERRI PEASE3 | 567 SAGUARO PLACE BARBERTON, OH 44203 | AFLAC | $4 | — | $4 | 0.05% |
| BRIAN L HUGGER3 | 10117 SOUTHEAST SUNNYSIDE ROAD SUITE F52 CLACKAMAS, OR 97015 | AFLAC | $4 | — | $4 | 0.05% |
| HARE AND ASSOCIATES LLC3 Filed as: HARE AND ASSOICATES LLC | 6324 TARTON FIELDS LANE MASON, OH 45040 | AFLAC | $3 | — | $3 | 0.03% |
| MICHAEL C WALKER3 Filed as: MICHAEL M STASTNY | 605 PORTLAND AVENUE UNIT 531 GLADSTONE, OR 97027 | AFLAC | $2 | — | $2 | 0.02% |
| THOMAS A HOUSE3 | 653 WEST OSCEOLA STREET APARTMENT C CLERMONT, FL 34147 | AFLAC | $2 | — | $2 | 0.02% |
| ERIC DANIEL WEILAND3 | 14511 SOUTHWEST CORNERSTONE LANE SHERWOOD, OR 97140 | AFLAC | $2 | — | $2 | 0.02% |
| JACK A SHADE3 | 1878 VERDICT RIDGE DRIVE DENVER, NC 28037 | AFLAC | $1 | — | $1 | 0.01% |
| CAMERON CARRILLO3 | 61503 ORION DRIVE BEND, OR 97702 | AFLAC | $1 | — | $1 | 0.01% |
| MATTHEW G BERGER3 Filed as: MATTHEW SHROYER | 1384 NORTHEAST 70TH AVENUE PORTLAND, OR 97213 | AFLAC | $1 | — | $1 | 0.01% |
| CURTIS A. ALMQUIST3 | 1665 NORTHWEST HIGHLAND DRIVE CORVALLIS, OR 97330 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $56 | — | $56 | 4.56% |
| HIPSTER ONCE LLC3 | 1665 NORTHWEST HIGHLAND DRIVE CORVALLIS, OR 97330 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $54 | — | $54 | 4.39% |
| JONATHAN BOOTH3 | 3844 NORTHEAST JOEL STREET MCMINNVILLE, OR 97128 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $27 | — | $27 | 2.20% |
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 | 147 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 148 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PROVIDENCE HEALTH PLAN | 115 | $1.6M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 507 | $98K |
| Vision | PROVIDENCE HEALTH PLAN | 115 | $1.6M |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 144 | $98K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 144 | $98K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 144 | $98K |
| Prescription drug | PROVIDENCE HEALTH PLAN | 115 | $1.6M |
| Other(4 contracts, 4 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 147 | $112K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 507 | — |
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.