| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PACIFIC BENEFIT CONSULTANTS3 Filed as: PACIFIC BENEFIT CONSULTANTS, INC. | 450 COUNTRY CLUB ROAD, SUITE 330 EUGENE, OR 974016078 | PROVIDENCE HEALTH PLAN | $21K | — | $21K | 2.03% |
| PACIFIC BENEFIT CONSULTANTS3 Filed as: PACIFIC BENEFIT CONSULTANTS INC | 450 COUNTRY CLUB RD STE 330 EUGENE, OR 974016078 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | — | $6K | 5.00% |
| JEANNETTE R. FRANSEN3 | 131 65TH PL. SPRINGFIELD, OR 97478 | AFLAC | $4K | $299 | $4K | 6.46% |
| DAVID FRANSEN3 | 131 65TH PL. SPRINGFIELD, OR 97478 | AFLAC | $3K | $263 | $3K | 4.57% |
| JEROMY E. CILLEY3 | 4660 MAIN ST. BLDG B STE 300 2 SPRINGFIELD, OR 97478 | AFLAC | $1K | $106 | $1K | 1.97% |
| GUY R SOUTER3 Filed as: GUY R. SOUTER | 2350 OAKMONT WAY STE 207 EUGENE, OR 97401 | AFLAC | $719 | $89 | $808 | 1.19% |
| BRUCE W. FORD3 | PO BOX 5734 KENT, WA 98064 | AFLAC | $521 | $88 | $609 | 0.90% |
| MARCI MARIE OTIS3 | 200 JULINA LN ROSEBURG, OR 97471 | AFLAC | $465 | — | $465 | 0.69% |
| PAUL MICHAEL HANNANT3 | 7180 SW FIR LOOP STE 250 TIGARD, OR 97223 | AFLAC | $264 | $96 | $360 | 0.53% |
| PAUL J BRIDGEMAN3 Filed as: PAUL J. BRIDGEMAN | 1600 B SW DASH POINT ROAD 263 FEDERAL WAY, WA 98023 | AFLAC | $243 | — | $243 | 0.36% |
| JAMES S SARANTIS3 Filed as: JAMES S. SARANTIS | 2251 DOUGLAS BLVD STE 110 ROSEVILLE, CA 95661 | AFLAC | $221 | $2 | $223 | 0.33% |
| DIANA CABRAL RENTCHLER3 | PO BOX 54 WEST SACRAMENTO, CA 95691 | AFLAC | $190 | $12 | $202 | 0.30% |
| KIMBERLY A PARKS3 Filed as: KIMBERLY A. PARKS | 3702 30TH AVE SE OLYMPIA, WA 98501 | AFLAC | $191 | — | $191 | 0.28% |
| MARK D LUTHER3 Filed as: MARK D. LUTHER | 804 MOOREFIELD PARK DR. STE 205 NORTH CHESTERFIELD, VA 23236 | AFLAC | $160 | — | $160 | 0.24% |
| DAVID N GUSTAFSON3 Filed as: DAVID N. GUSTAFSON | 340 EAST 41ST AVE EUGENE, OR 97405 | AFLAC | $159 | — | $159 | 0.24% |
| SCOTT NIELSEN3 Filed as: SCOTT E. NEILSEN | 1089 LAKE WASHINGTON BLVD N APT 306 RENTON, WA 98056 | AFLAC | $150 | — | $150 | 0.22% |
| MARY POHLMAN3 | 6102 90TH AVE SE MERCER ISLAND, WA 98040 | AFLAC | $131 | $18 | $149 | 0.22% |
| RICHARD G MCGOWAN3 Filed as: RICHARD MARK SUMMERS | 450 COUNTRY CLUB RD STE 330 EUGENE, OR 97401 | AFLAC | $105 | — | $105 | 0.16% |
| PHIL E DIETMEYER3 Filed as: PHIL E. DIETMEYER | 8275 SW COLONY CREEK CT. TIGARD, OR 97224 | AFLAC | $103 | $2 | $105 | 0.16% |
| BRANDON PENKO3 Filed as: BRANDON C. HOOBLER | 14220 INTERURBAN AVE S STE 150 SEATTLE, WA 98168 | AFLAC | $81 | $18 | $99 | 0.15% |
| GUY R SOUTER3 Filed as: GUY R. SOUTER | 16280 PINE DROP LN LA PINE, OR 97739 | AFLAC | $75 | $16 | $91 | 0.13% |
| DAVID J MCCLELLAN3 Filed as: DAVID JOHN HANNANT | 14830 NE 167TH ST. WOODINVILLE, WA 98072 | AFLAC | $57 | $18 | $75 | 0.11% |
| BRADLEY R. SWANK3 | PO BOX 872 SPRINGFIELD, OR 97477 | AFLAC | $72 | — | $72 | 0.11% |
| JEROMY E. CILLEY3 | 116 HWY 99N STE 108 EUGENE, OR 97402 | AFLAC | $70 | — | $70 | 0.10% |
| RAYMON P KEECH III3 Filed as: RAYMON P. KEECH III | 8207 CAMPAIGN CIR. RICHMOND, TX 77406 | AFLAC | $65 | — | $65 | 0.10% |
| ROBERT PILKENTON3 Filed as: ROBERT L. PILKENTON | 1100 CORPORATE WAY STE 100 SACRAMENTO, CA 95831 | AFLAC | $42 | — | $42 | 0.06% |
| ROBERTA LOU DIETMEYER3 | 8275 SW COLONY CREEK CT. TIGARD, OR 97224 | AFLAC | $38 | — | $38 | 0.06% |
| LISA M HUTCHERSON3 Filed as: LISA M. HUTCHERSON | 193 BLUE RAVINE RD. STE 140 FOLSOM, CA 95630 | AFLAC | $37 | — | $37 | 0.05% |
| DAVID B. KITCHEN3 | 1260 N. DUTTON AVE STE 180 SANTA ROSA, CA 95401 | AFLAC | $34 | $2 | $36 | 0.05% |
| STANLEY A MCPHERSON3 Filed as: STANLEY A. MCPHERSON | 2137 NE 38TH DR. GRESHAM, OR 97030 | AFLAC | $34 | $1 | $35 | 0.05% |
| PAUL A MARSHALL3 Filed as: PAUL A. MARSHALL | 555 S. RENTON VILLAGE PL. STE 160 RENTON, WA 98057 | AFLAC | $26 | — | $26 | 0.04% |
| CARLOS J. TORRES LAO3 | 7180 SW FIR LOOP STE 250 TIGARD, OR 97223 | AFLAC | $21 | $5 | $26 | 0.04% |
| HARRY R CONRAD3 Filed as: HARRY R. CONRAD | 2140 ELYSIUM AVE EUGENE, OR 97401 | AFLAC | $20 | — | $20 | 0.03% |
| GLEN T SCHWEIKERT3 Filed as: GLEN W. SUGGS | 2254 72ND AVENUE SE MERCER ISLAND, WA 98040 | AFLAC | $20 | — | $20 | 0.03% |
| SHELBIE NICOLE DIETMEYER3 | 8275 SW COLONY CREEK CT. TIGARD, OR 97224 | AFLAC | $20 | — | $20 | 0.03% |
| TODD M TAYLOR3 Filed as: TODD M. TAYLOR | 1720 TABOR ST. EUGENE, OR 97401 | AFLAC | $18 | — | $18 | 0.03% |
| ERNEST E SNOOK3 Filed as: ERNEST E. SNOOK | 14011 282ND LN. NE DUVALL, WA 98019 | AFLAC | $18 | — | $18 | 0.03% |
| LES HEINSEN INS SERVICES INC3 Filed as: LES HEINSEN INS SERVICES INC. | 4416 VIA PALAGIO FAIR OAKS, CA 95628 | AFLAC | $12 | $2 | $14 | 0.02% |
| MARY L ZACHARY3 Filed as: MARY L. ZACHARY | 18830 NW UKIAH ST. PORTLAND, OR 97229 | AFLAC | $12 | $2 | $14 | 0.02% |
| BARRY MCPHERSON INC3 Filed as: BARRY MCPHERSON INC. | 2211 MICHELSON DR. STE 1150 IRVINE, CA 92612 | AFLAC | $13 | — | $13 | 0.02% |
| ANGELA MARIE MCCOY3 | 5411 SW JOSHUA ST. TUALATIN, OR 97062 | AFLAC | $12 | — | $12 | 0.02% |
| RUSSELL HONDA3 Filed as: RUSSELL K. HONDA | 21932 SW CREEK DR. TUALATIN, OR 97062 | AFLAC | $9 | $2 | $11 | 0.02% |
| PETER JAMES SARANTIS3 | 2251 DOUGLAS BLVD STE 110 ROSEVILLE, CA 95661 | AFLAC | $9 | — | $9 | 0.01% |
| CAMERON CARRILLO3 Filed as: CAMERON D. CARRILLO | 22556 SW 96TH DR. TUALATIN, OR 97062 | AFLAC | $7 | $2 | $9 | 0.01% |
| SCOTT W BLACKSHEAR3 Filed as: SCOTT W. BLACKSHEAR | 3453 CATHRYN DR. COLUMBUS, GA 31906 | AFLAC | $6 | — | $6 | 0.01% |
| CHRISTOPHER WALLACE HOFF3 | 121 ROCKY POINT CT. ACWORTH, GA 30101 | AFLAC | $4 | $2 | $6 | 0.01% |
| MICHAEL C WALKER3 Filed as: MICHAEL L. ALLEY | 5200 MEADOWS RD. STE 150 LAKE OSWEGO, OR 97035 | AFLAC | $4 | — | $4 | 0.01% |
| BARRY A WHITE3 Filed as: BARRY A. WHITE | 4506 BANTAM WAY ELK GROVE, CA 95758 | AFLAC | $3 | — | $3 | 0.00% |
| BARRY LEE JOHNSON3 | 4890 48TH LOOP SWEET HOME, OR 97386 | AFLAC | $2 | — | $2 | 0.00% |
| PAUL B ROBEDEAU3 Filed as: PAUL B. ROBEDEAU | 9523 BAY CT. CARMEL, CA 93923 | AFLAC | $2 | — | $2 | 0.00% |
| JAMES F TUOR3 Filed as: JAMES F. TUOR | 22416 N. ARRELLAGA DR. SUN CITY WEST, AZ 85375 | AFLAC | $1 | — | $1 | 0.00% |
| CARLOS J. TORRES LAO3 | 6112 SW 18TH DR. APT 12 PORTLAND, OR 97239 | AFLAC | $1 | — | $1 | 0.00% |
| JEFFORY P MERTEN3 Filed as: JEFFORY P. MERTEN | 906 NW LEWISBURG AVE. CORVALLIS, OR 97330 | AFLAC | $1 | — | $1 | 0.00% |
| WILLIAM BONNER3 Filed as: WILLIAM RAYMOND BONNER | PO BOX 157 LEBANON, OR 97355 | AFLAC | $1 | — | $1 | 0.00% |
| MARK A MCRAE3 Filed as: MARK A. MCRAE | PO BOX 727 CORVALLIS, OR 97339 | AFLAC | $1 | — | $1 | 0.00% |
| PACIFIC BENEFIT CONSULTANTS3 | 450 COUNTRY CLUB RD STE 330 EUGENE, OR 974016078 | VISION SERVICE PLAN | $1K | — | $1K | 5.14% |
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 | 262 | 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) | 264 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PROVIDENCE HEALTH PLAN | 262 | $1.1M |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 222 | $113K |
| Vision | VISION SERVICE PLAN | 182 | $24K |
| Short-term disability | AFLAC | 126 | $68K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 262 | — |
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."
No prospect flags tripped on this filing.