| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE INC | 1111 GATEWAY LOOP SPRINGFIELD, OR 97477 | OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON | $4K | $0 | $4K | 2.48% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE INC | 1111 GATEWAY LOOP SPRINGFIELD, OR 97477 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $13K | $4K | $17K | 17.03% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE INC | 1111 GATEWAY LOOP SPRINGFIELD, OR 97477 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $1K | $0 | $1K | 6.00% |
| MELANIE KATE-MASON3 | PO BOX 906 PLEASANT HILL, OR 97455 | AFLAC | $856 | $0 | $856 | 5.03% |
| MARCI MARIE OTIS3 | 200 JULINA LANE ROSEBURG, OR 97471 | AFLAC | $532 | $87 | $619 | 3.64% |
| CAROL A. KENYON3 | 1645 CLEVELAND HILL ROAD ROSEBURG, OR 97471 | AFLAC | $434 | $62 | $496 | 2.91% |
| MJ INSURANCE3 Filed as: RICHARD SYFERT AND VARIOUS AGENTS | 86195 PANORAMA ROAD SPRINGFIELD, OR 97478 | AFLAC | $423 | $0 | $423 | 2.49% |
| JEROME E. CILLEY3 | 2683 EAST WILSHIRE DRIVE EUGENE, OR 97405 | AFLAC | $249 | $25 | $274 | 1.61% |
| RICHARD G MCGOWAN3 Filed as: RICHARD MARK SUMMERS | 450 COUNTRY CLUB ROAD, SUITE 330 EUGENE, OR 97401 | AFLAC | $177 | $0 | $177 | 1.04% |
| GARY R. SOUTER3 | PO BOX 1283 LA PINE, OR 97739 | AFLAC | $88 | $0 | $88 | 0.52% |
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 | 168 | 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) | 168 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON | 329 | $156K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 146 | $21K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 168 | $99K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 168 | $99K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 168 | $99K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 168 | $116K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 329 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.