| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 | PO BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | $43K | $9K | $52K | 19.75% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $3K | $3K | 1.29% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST, LLC | PO BOX 3018 BOTHELL, WA 98041 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $2K | $2K | 0.89% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST, LLC | 9340 SW BEAVERTON HILLSDALE HIGHWAY SUITE A BEAVERTON, OR 97005 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $47 | $47 | 0.02% |
| TAMARA MARIE QUARRY3 Filed as: TAMARA MARIE HAMPTON | 5250 HARDING LANE SE TURNER, OR 97392 | AFLAC | $9K | $0 | $9K | 13.93% |
| TREVOR WILKS3 | 722 HIGHLAND AVENUE NE SALEM, OR 97301 | AFLAC | $2K | $0 | $2K | 2.94% |
| MJ INSURANCE3 Filed as: MOLLIE KANSMAN AND VARIOUS AGENTS | 5225 HARDING LANE SE TURNER, OR 97392 | AFLAC | $977 | $0 | $977 | 1.59% |
| VINCENT BRIAN VOLLMAR3 | 4085 HAGER STREET SE, SUITE 300 SALEM, OR 97317 | AFLAC | $519 | $0 | $519 | 0.84% |
| JAN MARIE3 | PO BOX 3231 COEUR DALENE, ID 83816 | AFLAC | $458 | $0 | $458 | 0.75% |
| EVA KANSMAN3 | 5250 HARDIN LANE SE TURNER, OR 97392 | AFLAC | $455 | $0 | $455 | 0.74% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST, LLC | PO BOX 2329 LAKE OSWEGO, OR 97035 | AFLAC | $93 | $0 | $93 | 0.15% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST, LLC | PO BOX 3018 BOTHELL, WA 98041 | MEDICAL EYE SERVICES OF OREGON, INC. | $2K | $0 | $2K | 10.00% |
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. |
| 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) | 286 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 651 | $263K |
| Vision | MEDICAL EYE SERVICES OF OREGON, INC. | 271 | $20K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 651 | $324K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 651 | $324K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 651 | — |
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.