| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MJ INSURANCE3 Filed as: MJI INC. | PO BOX 847 MCMINNVILLE, OR 97128 | REGENCE BLUECROSS BLUESHIELD OF OREGON | $36K | $6K | $42K | 3.50% |
| MJ INSURANCE3 Filed as: MJI INC. | 448 SE BAKER STREET MCMINNVILLE, OR 97128 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $12K | $0 | $12K | 7.90% |
| REBECCA L. HILL3 | 1980 HOLLY AVENUE EUGENE, OR 97408 | AFLAC | $2K | $91 | $2K | 4.89% |
| RICHARD E. SYFERT3 | PO BOX 917 PLEASANT HILL, OR 97455 | AFLAC | $640 | $21 | $661 | 1.87% |
| BACKLUND & ASSOCIATES PC3 Filed as: BACKLUND AND ASSOCIATES | 1500 VALLEY RIVER DRIVE, SUITE 300 EUGENE, OR 97401 | AFLAC | $606 | $0 | $606 | 1.71% |
| JEROMY E. CILLEY3 | 2683 EAST WILSHIRE DRIVE EUGENE, OR 97405 | AFLAC | $582 | $0 | $582 | 1.64% |
| JOHN CAMERON TAYLOR & OTHER AGENTS3 Filed as: JOHN C. TAYLOR AND OTHER AGENTS | 923 SHERWOOD PLACE EUGENE, OR 97401 | AFLAC | $450 | $0 | $450 | 1.27% |
| GUY R SOUTER3 Filed as: GUY R. SOUTER | PO BOX 1283 LA PINE, OR 97739 | AFLAC | $205 | $0 | $205 | 0.58% |
| CHRISTOPHER EDWARD RUSSELL3 | 3333 SHELTON AVENUE EUGENE, OR 97405 | AFLAC | $166 | $21 | $187 | 0.53% |
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 | 120 | 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) | 120 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | REGENCE BLUECROSS BLUESHIELD OF OREGON | 183 | $1.2M |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 120 | $154K |
| Vision | REGENCE BLUECROSS BLUESHIELD OF OREGON | 183 | $1.2M |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 120 | $154K |
| Short-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 120 | $190K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 120 | $154K |
| Prescription drug | REGENCE BLUECROSS BLUESHIELD OF OREGON | 183 | $1.2M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 120 | $154K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 183 | — |
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.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.