| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| IMA, INC.3 | 430 EAST DOUGLAS, SUITE 400 WICHITA, KS 67202 | HARTFORD LIFE AND ACCIDENT | $10K | $0 | $10K | 6.00% |
| WATCHTOWER BENEFITS, LLC3 | 227 WEST MONROE STREET, SUITE 5200 CHICAGO, IL 60606 | HARTFORD LIFE AND ACCIDENT | $0 | $2K | $2K | 1.39% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE, INC. | PO BOX 784 SPRINGFIELD, OR 97477 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $0 | $2K | 7.12% |
| JEROMY E. CILLEY3 Filed as: JEROMY E. CILLEY AND OTHER AGENTS | 2683 EAST WILSHIRE DRIVE EUGENE, OR 97405 | AFLAC | $648 | $0 | $648 | 3.56% |
| MELANIE KATE-MASON3 | 85699 CHELSEA LANE EUGENE, OR 97405 | AFLAC | $477 | $0 | $477 | 2.62% |
| CAROL A. KENYON3 | 1645 CLEVELAND HILL ROAD ROSEBURG, OR 97471 | AFLAC | $234 | $0 | $234 | 1.29% |
| LUKE J WITTROCK3 Filed as: LUKE J. WITTROCK | PO BOX 701 BOONE, IA 50036 | AFLAC | $182 | $0 | $182 | 1.00% |
| MARCI MARIE OTIS3 | 200 JULINA LANE ROSEBURG, OR 97471 | AFLAC | $164 | $0 | $164 | 0.90% |
| RICHARD G MCGOWAN3 Filed as: RICHARD MARK SUMMERS | 450 COUNTRY CLUB ROAD, SUITE 330 EUGENE, OR 97401 | AFLAC | $139 | $0 | $139 | 0.76% |
| TABBITHA ROSE3 Filed as: TABBITHA LOREN ROSE | 655 WALNUT DRIVE MELBOURNE, FL 32935 | AFLAC | $118 | $0 | $118 | 0.65% |
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 | 230 | 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) | 230 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 508 | $28K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 230 | $171K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 230 | $171K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 230 | $171K |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 230 | $189K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 508 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.