| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| UNKNOWN3 | UNKNOWN HALSEY, OR 97348 | OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON | $4K | $0 | $4K | 2.50% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE INC | 1111 GATEWAY LOOP SPRINGFIELD, OR 97477 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $14K | $0 | $14K | 13.63% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE INC | 1111 GATEWAY LOOP SPRINGFIELD, OR 97477 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $1K | $0 | $1K | 5.91% |
| MELANIE KATE-MASON3 | PO BOX 906 PLEASANT HILL, OR 97455 | AFLAC | $999 | $25 | $1K | 5.71% |
| MARCI MARIE OTIS3 | 200 JULINA LANE ROSEBURG, OR 97471 | AFLAC | $963 | $0 | $963 | 5.37% |
| CAROL A. KENYON3 | 1645 CLEVELAND HILL ROAD ROSEBURG, OR 97471 | AFLAC | $785 | $0 | $785 | 4.37% |
| JEROME E. CILLEY3 | 1115 PEARL STREET EUGENE, OR 97401 | AFLAC | $463 | $5 | $468 | 2.61% |
| MJ INSURANCE3 Filed as: SHARON DOUGLASS AND VARIOUS AGENTS | 702 PATROL STREET MOLALLA, OR 97038 | AFLAC | $339 | $5 | $344 | 1.92% |
| RICHARD G MCGOWAN3 Filed as: RICHARD MARK SUMMERS | 450 COUNTRY CLUB ROAD, SUITE 330 EUGENE, OR 97401 | AFLAC | $189 | $0 | $189 | 1.05% |
| GUY R SOUTER3 Filed as: GUY R. SOUTER | PO BOX 1283 LA PINE, OR 97739 | AFLAC | $101 | $0 | $101 | 0.56% |
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 | 177 | 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) | 177 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON | 452 | $168K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 158 | $23K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 177 | $103K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 177 | $103K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 177 | $103K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 177 | $121K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 452 | — |
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.