| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNEWEST INSURANCE | — | MODA HEALTH | $14K | — | $14K | 1.92% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNEWEST INSURANCE | — | OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON | $694 | — | $694 | 1.92% |
| JOSEPH P CALARCO3 Filed as: JOSEPH J CANEPA | PO BOX 9013 BEND, OR 97708 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3K | — | $3K | 9.54% |
| RYAN GEORGE KRUIT3 Filed as: RYAN G KRUIT | 300 SOUTHEAST REED MARKET ROAD SUITE 320 BEND, OR 97702 | CONTINENTAL AMERICAN INSURANCE COMPANY | $631 | — | $631 | 1.78% |
| RICHARD J ROSS3 | 63146 WATERCRESS WAY BEND, OR 97701 | CONTINENTAL AMERICAN INSURANCE COMPANY | $87 | — | $87 | 0.25% |
| GUY R SOUTER3 | 2350 OAKMONT WAY SUITE 207 EUGENE, OR 97401 | CONTINENTAL AMERICAN INSURANCE COMPANY | $27 | — | $27 | 0.08% |
| VINCENT BRIAN VOLLMAR3 Filed as: VINCENT B VOLLMAR | 3230 DOGWOOD DRIVE SOUTH SALEM, OR 97302 | CONTINENTAL AMERICAN INSURANCE COMPANY | $18 | — | $18 | 0.05% |
| SHEILA M LAFLAMME3 | 1426 EAST IRON EAGLE DRIVE EAGLE, ID 83616 | CONTINENTAL AMERICAN INSURANCE COMPANY | $10 | — | $10 | 0.03% |
| PATRICIA GEE3 | 70 SOUTHWEST CENTURY DRIVE 100-153 BEND, OR 97702 | CONTINENTAL AMERICAN INSURANCE COMPANY | $8 | — | $8 | 0.02% |
| ANDRE LAFLAMME3 Filed as: ANDRE LEON LAFLAMME | 9007 46TH COURT NORTHWEST GIG HARBOR, WA 98335 | CONTINENTAL AMERICAN INSURANCE COMPANY | $8 | — | $8 | 0.02% |
| RAYMON P KEECH III3 | 8207 CAMPAIGN CIRCLE RICHMOND, TX 77406 | CONTINENTAL AMERICAN INSURANCE COMPANY | $4 | — | $4 | 0.01% |
| KIMBERLY A PARKS3 | 19818 NORTH 147TH DRIVE SUN CITY WEST, AZ 85375 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3 | — | $3 | 0.01% |
| CAMERON CARRILLO3 | 22556 SOUTHWEST 96TH DRIVE TUALATIN, OR 97062 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| ROBIN D HUDSON3 | PO BOX 298 BENICIA, CA 94510 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| SHANE EDMUND ATTEBERY3 Filed as: SHANE E ATTEBERY | 2824 SOUTH RIVER ROAD GRANTS PASS, OR 97527 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| MATTHEW S SHROYER3 | 7407 NORTH WILLIAMS AVENUE PORTLAND, OR 97217 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNEWEST INSURANCE | — | OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON | $503 | — | $503 | 1.92% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNEWEST INSURANCE INC | 2925 PALMER STREET SUITE B MISSOULA, MT 59806 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | $230 | $4K | 15.92% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNEWEST INSURANCE INC | 2925 PALMER STREET SUITE B MISSOULA, MT 59806 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | $156 | $1K | 17.11% |
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 | 106 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 107 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MODA HEALTH | 104 | $737K |
| Dental(2 contracts) | OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON | 60 | $62K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 106 | $7K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 106 | $25K |
| Other(3 contracts, 3 carriers) | CONTINENTAL AMERICAN INSURANCE COMPANY | 161 | $45K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 161 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.