| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SHELLI LITTLEFIELD3 | PACIFIC BENEFIT CONSULTANTS, INC. 450 COUNTRY CLUB ROAD, SUITE 330 EUGENE, OR 974016078 | PROVIDENCE HEALTH PLAN | $40K | — | $40K | 3.02% |
| 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% |
| DAVID FRANSEN3 | 131 65TH PL. SPRINGFIELD, OR 97478 | AFLAC | $3K | $171 | $4K | 4.25% |
| JEANNETTE R. FRANSEN3 | 131 65TH PL. SPRINGFIELD, OR 97478 | AFLAC | $3K | $56 | $3K | 3.88% |
| RICHARD E. SYFERT3 Filed as: RICHARD E SYFERT | PO BOX 917 PLEASANT HILL, OR 97455 | AFLAC | $2K | $58 | $2K | 2.68% |
| JEANNETTE R. FRANSEN3 Filed as: JEANNETTE R FRANSEN | 131 65TH PL SPRINGFIELD, OR 97478 | AFLAC | $2K | $69 | $2K | 2.37% |
| PHILIP O MCGUIGAN3 | PO BOX 24021 EUGENE, OR 97402 | AFLAC | $947 | — | $947 | 1.11% |
| DIANA CABRAL RENTCHLER3 | PO BOX 54 WEST SACRAMENTO, CA 95691 | AFLAC | $906 | $39 | $945 | 1.11% |
| JEROMY E. CILLEY3 Filed as: JEROMY E CILLEY | 2683 E WILSHIRE DR EUGENE, OR 97405 | AFLAC | $817 | $56 | $873 | 1.03% |
| PHIL E DIETMEYER3 | 8275 SW COLONY CREEK CT TIGARD, OR 97224 | AFLAC | $414 | $43 | $457 | 0.54% |
| RYAN DONALD AUGHENBAUGH3 | 16543 S WINDY CITY RD MULINO, OR 97042 | AFLAC | $268 | $39 | $307 | 0.36% |
| LEON NORMAN DAVIDSON3 | 1230 ARROYO GRANDE DR SACRAMENTO, CA 95864 | AFLAC | $240 | $8 | $248 | 0.29% |
| MARCI MARIE OTIS3 | 200 JULINA LN ROSEBURG, OR 97471 | AFLAC | $247 | — | $247 | 0.29% |
| PAUL J BRIDGEMAN3 | 1600 SW DASH POINT RD STE B #263 FEDERAL WAY, WA 98023 | AFLAC | $224 | — | $224 | 0.26% |
| GUY R SOUTER3 | PO BOX 1283 LA PINE, OR 97739 | AFLAC | $170 | — | $170 | 0.20% |
| JOHNNY WAYNE ROBBINS3 | 29744 AWBREY LN UNIT B EUGENE, OR 97402 | AFLAC | $153 | — | $153 | 0.18% |
| BRUCE W. FORD3 Filed as: BRUCE W FORD | PO BOX 5734 KENT, WA 98064 | AFLAC | $148 | — | $148 | 0.17% |
| JAMES S SARANTIS3 | 14132 SE FIRCREST CT PORTLAND, OR 97236 | AFLAC | $133 | — | $133 | 0.16% |
| DAVID N GUSTAFSON3 | 340 E 41ST AVE EUGENE, OR 97405 | AFLAC | $121 | — | $121 | 0.14% |
| L & T ENT LLC3 | 2769 SW ELMER NELSON LN GRANTS PASS, OR 97527 | AFLAC | $85 | $14 | $99 | 0.12% |
| KIMBERLY A PARKS3 | 19818 N 147TH DR SUN CITY WEST, AZ 85375 | AFLAC | $81 | — | $81 | 0.10% |
| MARY POHLMAN3 | 27735 214TH AVE SE MAPLE VALLEY, WA 98038 | AFLAC | $80 | — | $80 | 0.09% |
| G SCOTT COOKE3 Filed as: SCOTT E NIELSEN | 718B W FOURTH PLAIN BLVD VANCOUVER, WA 98660 | AFLAC | $76 | — | $76 | 0.09% |
| JACE G KUERSTEN3 | 1574 SAN FERNANDO DR CORONA, CA 92882 | AFLAC | $68 | $8 | $76 | 0.09% |
| MICHAEL W. ATTERBERRY3 Filed as: MICHAEL J KUVAAS | 2300 OAKMONT WAY STE 203 EUGENE, OR 97401 | AFLAC | $56 | — | $56 | 0.07% |
| ANDY B GLENN II3 | 2281 LAVA RIDGE CT STE 130 ROSEVILLE, CA 95661 | AFLAC | $56 | — | $56 | 0.07% |
| RICHARD G MCGOWAN3 Filed as: RICHARD MARK SUMMERS | 450 COUNTRY CLUB RD STE 330 EUGENE, OR 97401 | AFLAC | $52 | — | $52 | 0.06% |
| MARK D LUTHER3 | 1400 MAIN ST APT 610 CANONSBURG, PA 15317 | AFLAC | $43 | — | $43 | 0.05% |
| PAUL MICHAEL HANNANT3 | 6052 SAWGRASS ST SE SALEM, OR 97306 | AFLAC | $41 | — | $41 | 0.05% |
| BRADLEY R. SWANK3 Filed as: BRADLEY R SWANK | PO BOX 872 SPRINGFIELD, OR 97477 | AFLAC | $38 | — | $38 | 0.04% |
| LISA M HUTCHERSON3 | 5690 LILYVIEW WAY ELK GROVE, CA 95757 | AFLAC | $35 | — | $35 | 0.04% |
| ROBERT PILKENTON3 Filed as: ROBERT L PILKENTON | 6643 FM 2187 RD SEALY, TX 77474 | AFLAC | $34 | — | $34 | 0.04% |
| RAYMON P KEECH III3 | 8207 CAMPAIGN CIR RICHMOND, TX 77406 | AFLAC | $33 | — | $33 | 0.04% |
| DAVID B. KITCHEN3 Filed as: DAVID B KITCHEN | 1260 N DUTTON AVE STE 180 SANTA ROSA, CA 95401 | AFLAC | $29 | — | $29 | 0.03% |
| BRANDON PENKO3 Filed as: BRANDON C HOOBLER | 1230 S 336TH ST STE A FEDERAL WAY, WA 98003 | AFLAC | $27 | — | $27 | 0.03% |
| RUSSELL HONDA3 Filed as: RUSSELL K HONDA | 11865 SW TUALATIN RD APT 73 TUALATIN, OR 97062 | AFLAC | $25 | — | $25 | 0.03% |
| PAUL A MARSHALL3 | 555 S RENTON VILLAGE PL STE 160 RENTON, WA 98057 | AFLAC | $24 | — | $24 | 0.03% |
| CARLOS J. TORRES LAO3 Filed as: CARLOS J TORRES LAO | 7180 SW FIR LOOP STE 250 TIGARD, OR 97223 | AFLAC | $20 | — | $20 | 0.02% |
| GLEN T SCHWEIKERT3 Filed as: GLEN W SUGGS | 2254 72ND AVE SE MERCER ISLAND, WA 98040 | AFLAC | $18 | — | $18 | 0.02% |
| STANLEY A MCPHERSON3 | 9090 SE 242ND AVE DAMASCUS, OR 97089 | AFLAC | $18 | — | $18 | 0.02% |
| SHANE EDMUND ATTEBERY3 | 391 RANDY DR GRANTS PASS, OR 97527 | AFLAC | $16 | — | $16 | 0.02% |
| IOANNIS T GRATSINOPOULOS3 | 1893 E DAULBY ST MERIDIAN, ID 83642 | AFLAC | $15 | — | $15 | 0.02% |
| ROBERTA LOU DIETMEYER3 | 8275 SW COLONY CREEK CT TIGARD, OR 97224 | AFLAC | $15 | — | $15 | 0.02% |
| ERNEST E SNOOK3 | 14011 282ND LN NE DUVALL, WA 98019 | AFLAC | $13 | — | $13 | 0.02% |
| BARRY MCPHERSON INC3 | 2211 MICHELSON DR STE 1150 IRVINE, CA 92612 | AFLAC | $12 | — | $12 | 0.01% |
| SHELBIE NICOLE DIETMEYER3 | 8275 SW COLONY CREEK CT TIGARD, OR 97224 | AFLAC | $12 | — | $12 | 0.01% |
| SHEREEN EMDE3 | 6449 HIGHWAY 219 NE GERVAIS, OR 97026 | AFLAC | $12 | — | $12 | 0.01% |
| ROBERT PILKENTON3 Filed as: ROBERT L PILKENTON | 1100 CORPORATE WAY STE 100 SACRAMENTO, CA 95831 | AFLAC | $11 | — | $11 | 0.01% |
| LES HEINSEN INS SERVICES INC3 | 4416 VIA PALAGIO FAIR OAKS, CA 95628 | AFLAC | $11 | — | $11 | 0.01% |
| TODD M TAYLOR3 | 3670 WESTWARD HO AVE EUGENE, OR 97401 | AFLAC | $11 | — | $11 | 0.01% |
| ERIC DANIEL WEILAND3 | 14511 SW CORNERSTONE LN SHERWOOD, OR 97140 | AFLAC | $10 | — | $10 | 0.01% |
| CHARLES H WEISSBERGER3 | 5128 CREEKMONTE DR ROCHESTER, MI 48306 | AFLAC | $9 | — | $9 | 0.01% |
| PETER JAMES SARANTIS3 | 7775 DUTRA BEND DR SACRAMENTO, CA 95831 | AFLAC | $8 | — | $8 | 0.01% |
| KENNETH MAGEE3 | 3760 MARKET ST NE 347 SALEM, OR 97301 | AFLAC | $8 | — | $8 | 0.01% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INS INC | C/O ROBERT WEEKS PO BOX 29 SPRINGFIELD, OR 97477 | AFLAC | $8 | — | $8 | 0.01% |
| MARY L ZACHARY3 | 18830 NW UKIAH ST PORTLAND, OR 97229 | AFLAC | $7 | — | $7 | 0.01% |
| ANGELA MARIE MCCOY3 | 5411 SW JOSHUA ST TUALATIN, OR 97062 | AFLAC | $7 | — | $7 | 0.01% |
| SCOTT W BLACKSHEAR3 | 181 OLETA WAY ST AUGUSTINE, FL 32095 | AFLAC | $6 | — | $6 | 0.01% |
| JACOB J MCINTOSH3 | 665 S WOODRUFF AVE STE 250 IDAHO FALLS, ID 83401 | AFLAC | $5 | — | $5 | 0.01% |
| MICHAEL C WALKER3 Filed as: MICHAEL A STACHOWIAK | 321 N CLARK ST STE 615 CHICAGO, IL 60654 | AFLAC | $5 | — | $5 | 0.01% |
| CAMERON CARRILLO3 Filed as: CAMERON D CARRILLO | 61503 ORION DR BEND, OR 97702 | AFLAC | $5 | — | $5 | 0.01% |
| ALICA J MATSON3 | 6027 ROLLETTI DR SE SALEM, OR 97306 | AFLAC | $5 | — | $5 | 0.01% |
| MATTHEW G BERGER3 Filed as: MATTHEW SHROYER | 1384 NE 70TH AVE PORTLAND, OR 97213 | AFLAC | $5 | — | $5 | 0.01% |
| HARRY R CONRAD3 | 2140 ELYSIUM AVE EUGENE, OR 97401 | AFLAC | $4 | — | $4 | 0.00% |
| MICHAEL C WALKER3 Filed as: MICHAEL L ALLEY | 2189 SE 12TH AVE CANBY, OR 97013 | AFLAC | $4 | — | $4 | 0.00% |
| GINA SIENIA3 | PO BOX 446 ECHO, OR 97826 | AFLAC | $4 | — | $4 | 0.00% |
| MICHAEL C WALKER3 Filed as: MICHAEL M STASTNY | 605 PORTLAND AVE UNIT 531 GLADSTONE, OR 97027 | AFLAC | $3 | — | $3 | 0.00% |
| AMANDA M GRIFFITH3 | 11400 SE 8TH ST STE 375 BELLEVUE, WA 98004 | AFLAC | $3 | — | $3 | 0.00% |
| BRIDGET RENEA TOWNSEND3 | 28317 SW PARIS AVE WILSONVILLE, OR 97070 | AFLAC | $3 | — | $3 | 0.00% |
| AMY E COHEN3 Filed as: AMY MARIE LUDWICK | 316 BARBATO LN SACRAMENTO, CA 95814 | AFLAC | $3 | — | $3 | 0.00% |
| MICHAEL C WALKER3 Filed as: MICHAEL JAMES RHODD | 4160 GREEN VALLEY RD FAIRFIELD, CA 94534 | AFLAC | $3 | — | $3 | 0.00% |
| BARRY A WHITE3 Filed as: BARRY WHITE | 4506 BANTAM WAY ELK GROVE, CA 95758 | AFLAC | $2 | — | $2 | 0.00% |
| CHRISTOPHER WALLACE HOFF3 | 22996 SW LODGEPOLE AVE TUALATIN, OR 97062 | AFLAC | $2 | — | $2 | 0.00% |
| BRIAN E DICKSON3 | 8905 SW NIMBUS AVE 375 BEAVERTON, OR 97008 | AFLAC | $2 | — | $2 | 0.00% |
| PAUL B ROBEDEAU3 | 9523 BAY CT CARMEL, CA 93923 | AFLAC | $1 | — | $1 | 0.00% |
| SIERRA N KIRSHY3 | 348 DIAMOND OAKS RD ROSEVILLE, CA 95678 | AFLAC | $1 | — | $1 | 0.00% |
| RUSSELL W REOPELLE3 | 1211 BILLY FRANK JR ST APT 1 BELLINGHAM, WA 98225 | AFLAC | $1 | — | $1 | 0.00% |
| MJ INSURANCE3 Filed as: ROBIN D HUDSON | 22100 NE HALSEY ST APT 354 FAIRVIEW, OR 97024 | AFLAC | $1 | — | $1 | 0.00% |
| PETER JAMES SARANTIS3 | 26200 TOWN CENTER DR STE 110 NOVI, MI 48375 | AFLAC | $1 | — | $1 | 0.00% |
| HEATHER F CHRISTENSEN3 | PO BOX 784 MORONI, UT 84646 | AFLAC | $1 | — | $1 | 0.00% |
| MEGAN ELIZABETH CASTO3 Filed as: MEGAN J STEVENSON | 33305 1ST WAY S STE B203 FEDERAL WAY, WA 98003 | AFLAC | $1 | — | $1 | 0.00% |
| MITCHELL HECTOR MORALES3 Filed as: MITCHELL PUMPIAN | 225 NE BIRCH ST ISSAQUAH, WA 98027 | AFLAC | $1 | — | $1 | 0.00% |
| PACIFIC BENEFIT CONSULTANTS3 | 450 COUNTRY CLUB RD STE 330 EUGENE, OR 974016078 | VISION SERVICE PLAN | $1K | — | $1K | 4.70% |
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 | 286 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 286 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PROVIDENCE HEALTH PLAN | 286 | $1.3M |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 292 | $128K |
| Vision | VISION SERVICE PLAN | 256 | $30K |
| Short-term disability | AFLAC | 124 | $85K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 292 | — |
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.