| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VICTORIA L FLYNN3 Filed as: VICTORIA SCHROEDER | — | SAMARITAN HEALTH PLANS | $31K | $150 | $31K | 3.22% |
| TIFFANY M HEBERT3 | 567 SOUTHEAST CYPRESS AVENUE DALLAS, OR 97338 | AFLAC | $4K | $232 | $4K | 8.75% |
| MICHEL RAYMOND3 | 4485 LONG STREET SWEET HOME, OR 97386 | AFLAC | $2K | $303 | $2K | 4.49% |
| VINCENT BRIAN VOLLMAR3 | 777 COMMERCE DRIVE SOUTHEAST SUITE 20 SALEM, OR 97301 | AFLAC | $853 | $102 | $955 | 2.05% |
| CHERYL L. BONNER3 Filed as: CHERYL L BONNER | 2754 TANGENT WAY SOUTHEAST SALEM, OR 97317 | AFLAC | $443 | — | $443 | 0.95% |
| RODRIGO SALINAS3 | 5040 DURANGO COURT SOUTHEAST SALEM, OR 97306 | AFLAC | $403 | — | $403 | 0.87% |
| RHODES WARDEN INS AGCY3 Filed as: RHODES-WARDEN INSURANCE, INC. | PO BOX 8 LEBANON, OR 97355 | AFLAC | $376 | — | $376 | 0.81% |
| ROBERT ALLEN WHEELER3 | 645 NORTHWEST EVE DRIVE DALLAS, OR 97338 | AFLAC | $184 | — | $184 | 0.40% |
| JOYCE ANN HARRER3 | 8555 NORTHEAST DOG RIDGE ROAD NEWBERG, OR 97132 | AFLAC | $182 | — | $182 | 0.39% |
| THERESA LYNN HANE3 | PO BOX 2996 LA PINE, OR 97739 | AFLAC | $175 | — | $175 | 0.38% |
| ALICIA J MATSON3 | 6027 ROLLETTI DRIVE SOUTHEAST SALEM, OR 97306 | AFLAC | $164 | — | $164 | 0.35% |
| SCOTT LYDA3 Filed as: SCOTT KEITH SHOWERS | 259 DORCAS DRIVE NORTH KEIZER, OR 97303 | AFLAC | $96 | $38 | $134 | 0.29% |
| HOLLY HALL3 | 505 NORTH ARGONNE ROAD BUILDING C SPOKANE VALLEY, WA 99212 | AFLAC | $114 | — | $114 | 0.24% |
| TAMARA MARIE QUARRY3 | 5250 HARDING LANE SOUTHEAST TURNER, OR 97392 | AFLAC | $86 | — | $86 | 0.18% |
| JOSEPH P TYRRELL3 | 468 EAST FOREST RIDGE DRIVE MERIDIAN, ID 83642 | AFLAC | $64 | — | $64 | 0.14% |
| RAYMOND P KEECH III3 | 8207 CAMPAIGN CIRCLE RICHMOND, TX 77406 | AFLAC | $50 | — | $50 | 0.11% |
| CHERYL DOWNING3 | 496 INVERNESS DRIVE SOUTHEAST SALEM, OR 97306 | AFLAC | $46 | — | $46 | 0.10% |
| MARCI MARIE OTIS3 | 200 JULINA LANE ROSEBURG, OR 97471 | AFLAC | $30 | — | $30 | 0.06% |
| MARK A MCRAE3 | 375 NORTHEAST SOUTH NEBERGALL LOOP ALBANY, OR 97321 | AFLAC | $29 | — | $29 | 0.06% |
| EDWARD D NALLEY3 | 1110 MAIN STREET APARTMENT 3 DALLAS, OR 97338 | AFLAC | $19 | $6 | $25 | 0.05% |
| KIMBERLY A PARKS3 | 19818 NORTH 147TH DRIVE SUN CITY WEST, AZ 85375 | AFLAC | $22 | — | $22 | 0.05% |
| PAULA LYNN BIRCHFIELD3 | 1585 WAVERLY DRIVE SOUTHEAST APARTMENT 101 ALBANY, OR 97322 | AFLAC | $19 | — | $19 | 0.04% |
| JOSHUA ANDERSON3 | 1341 NORTH 16TH STREET MONMOUTH, OR 97361 | AFLAC | $18 | — | $18 | 0.04% |
| G SCOTT COOKE3 Filed as: SCOTT E NIELSEN | 718B WEST FOURTH PLAIN BOULEVARD VANCOUVER, WA 98660 | AFLAC | $17 | — | $17 | 0.04% |
| DAVID J MCCLELLAN3 Filed as: DAVID JOHN HANNANT | 14830 NORTHEAST 167TH STEET WOODINVILLE, WA 98072 | AFLAC | $15 | — | $15 | 0.03% |
| SHANE EDMUND ATTEBERY3 | 391 RANDY DRIVE GRANTS PASS, OR 97527 | AFLAC | $14 | — | $14 | 0.03% |
| ZINA SHADRIN3 | PO BOX 1704 LAKE OSWEGO, OR 97035 | AFLAC | $13 | — | $13 | 0.03% |
| PAULLA ANN WALKER3 | 601 IDYLWOOD DRIVE SOUTHEAST SALEM, OR 97302 | AFLAC | $9 | — | $9 | 0.02% |
| ROBIN D HUDSON3 | 22100 NORTHEAST HALSEY STREET APARTMENT 354 FAIRVIEW, OR 97024 | AFLAC | $8 | — | $8 | 0.02% |
| PAUL GLOBAL BENEFITS INC3 Filed as: PAUL MICHAEL HANNANT | 6052 SAWGRASS STREET SOUTHEAST SALEM, OR 97306 | AFLAC | $6 | — | $6 | 0.01% |
| MATTHEW G BERGER3 Filed as: MATTHEW SHROYER | 1384 NORTHEAST 70TH AVENUE PORTLAND, OR 97213 | AFLAC | $6 | — | $6 | 0.01% |
| CAMERON CARRILLO3 | 61503 ORION DRIVE BEND, OR 97702 | AFLAC | $4 | — | $4 | 0.01% |
| IOANNIS T GRATSINOPOULOS3 | 1893 EAST DAULBY STREET MERIDIAN, ID 83642 | AFLAC | $3 | — | $3 | 0.01% |
| TREVOR WILKS3 | 722 HIGHLAND AVENUE NORTHEAST SALEM, OR 97301 | AFLAC | $1 | — | $1 | 0.00% |
| ERIC DANIEL WEILAND3 | 14511 SOUTHWEST CORNERSTONE LANE SHERWOOD, OR 97140 | AFLAC | $1 | — | $1 | 0.00% |
| RHODES WARDEN INS AGCY3 Filed as: RHODES-WARDEN INS. AGENCY INC. | — | WILLAMETTE DENTAL INSURANCE, INC. | $2K | — | $2K | 5.00% |
| RHODES WARDEN INS AGCY3 | PO BOX 8 LEBANON, OR 97355 | STANDARD INSURANCE COMPANY | $1K | — | $1K | 4.35% |
| RHODES WARDEN INS AGCY3 | PO BOX 8 LEBANON, OR 97355 | STANDARD INSURANCE COMPANY | $658 | — | $658 | 6.00% |
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 | 110 | 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) | 110 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | SAMARITAN HEALTH PLANS | 117 | $963K |
| Dental(2 contracts, 2 carriers) | WILLAMETTE DENTAL INSURANCE, INC. | 64 | $73K |
| Life insurance | STANDARD INSURANCE COMPANY | 111 | $11K |
| Other(2 contracts, 2 carriers) | AFLAC | 111 | $58K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 117 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.