| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 Filed as: BOON CHAPMEN BENEFIT ADMINISTRATORS | PO BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | $41K | $6K | $47K | 18.58% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERATIONAL NORTHWEST LLC | 9340 SW BEAVERTON HILLSDALE HIGHWAY SUITE A BEAVERTON, OR 97005 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $65 | $65 | 0.03% |
| TAMARA MARIE QUARRY3 Filed as: TAMARA MARIE HAMPTON | 5250 HARDING LANE SE TURNER, OR 97392 | AFLAC | $10K | $507 | $10K | 15.56% |
| TREVOR WILKS3 | 722 HIGHLAND AVENUE NE SALEM, OR 97301 | AFLAC | $3K | $109 | $3K | 4.56% |
| TIFFANY M HEBERT3 | 567 SE CYPRESS AVENUE DALLAS, OR 97338 | AFLAC | $3K | $0 | $3K | 3.96% |
| ANDREW N LUCCOCK3 Filed as: ANDREW N LUCCOCK AND OTHER AGENTS | 22680 SW JAQUITH ROAD NEWBERG, OR 97132 | AFLAC | $505 | $74 | $579 | 0.86% |
| MOLLIE KANSMAN3 | 5225 HARDING LANE SE TURNER, OR 97392 | AFLAC | $372 | $29 | $401 | 0.60% |
| VINCENT BRIAN VOLLMAR3 Filed as: VINCENT BRAIN VOLLMAR | 4085 HAGER STREET SE, SUITE 300 SALEM, OR 97317 | AFLAC | $299 | $0 | $299 | 0.45% |
| PAULLA ANN WALKER3 | 601 IDYLWOOD DRIVE SE SALEM, OR 97302 | AFLAC | $206 | $0 | $206 | 0.31% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | UNKNWON SALEM, OR 97303 | 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 | 295 | 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) | 295 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 549 | $251K |
| Vision | MEDICAL EYE SERVICES OF OREGON, INC. | 316 | $22K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 549 | $318K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 549 | $318K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 549 | — |
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.