| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | $7K | $16K | 18.94% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | LIFEMAP ASSURANCE COMPANY | $837 | $778 | $2K | 9.58% |
| MARCI MARIE OTIS3 | 200 JULINA LANE ROSEBURG, OR 97471 | AFLAC | $270 | $18 | $288 | 5.05% |
| PHILIP O MCGUIGAN3 Filed as: PHILIP O. MCGUIGAN | PO BOX 24021 EUGENE, OR 97402 | AFLAC | $174 | $35 | $209 | 3.67% |
| CAROL A. KENYON3 | 1645 CLEVELAND HILL ROAD ROSEBURG, OR 97471 | AFLAC | $162 | $18 | $180 | 3.16% |
| RICHARD E. SYFERT3 Filed as: RICHARD E. SYFERT AND OTHER AGENTS | PO BOX 917 PLEASANT HILL, OR 97455 | AFLAC | $86 | $17 | $103 | 1.81% |
| VINCENT BRIAN VOLLMAR3 | 4085 HAGER STREET SE, SUITE 300 SALEM, OR 97317 | AFLAC | $65 | $17 | $82 | 1.44% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 975 OAK STREET, SUITE 900 EUGENE, OR 97401 | AFLAC | $55 | $0 | $55 | 0.96% |
| JEROMY E. CILLEY3 | 2683 EAST WILSHIRE DRIVE EUGENE, OR 97405 | AFLAC | $45 | $0 | $45 | 0.79% |
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 | 220 | 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) | 220 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | WILLAMETTE DENTAL INSURANCE, INC. | 98 | $55K |
| Vision | LIFEMAP ASSURANCE COMPANY | 124 | $17K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 161 | $86K |
| Short-term disability | AFLAC | 6 | $6K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 161 | $86K |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 220 | $97K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 220 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.