| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNEWEST INSURANCE | — | MODA HEALTH | $10K | — | $10K | 1.25% |
| MARSH & MCLENNAN AGENCY LLC3 | — | MODA HEALTH | $5K | — | $5K | 0.60% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNEWEST INSURANCE | — | OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON | $478 | — | $478 | 1.25% |
| MARSH & MCLENNAN AGENCY LLC3 | — | OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON | $230 | — | $230 | 0.60% |
| JOSEPH P CALARCO3 Filed as: JOSEPH J CANEPA | PO BOX 9013 BEND, OR 97708 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | — | $2K | 4.94% |
| RYAN GEORGE KRUIT3 Filed as: RYAN G KRUIT | 300 SOUTHEAST REED MARKET DRIVE SUITE 320 BEND, OR 97702 | CONTINENTAL AMERICAN INSURANCE COMPANY | $363 | — | $363 | 1.02% |
| RICHARD J ROSS3 | 63146 WATERCRESS WAY BEND, OR 97701 | CONTINENTAL AMERICAN INSURANCE COMPANY | $40 | — | $40 | 0.11% |
| GUY R SOUTER3 | 2350 OAKMONT WAY SUITE 207 EUGENE, OR 97401 | CONTINENTAL AMERICAN INSURANCE COMPANY | $15 | — | $15 | 0.04% |
| PATRICIA GEE3 | 70 SOUTHWEST CENTURY DRIVE 100-153 BEND, OR 97702 | CONTINENTAL AMERICAN INSURANCE COMPANY | $5 | — | $5 | 0.01% |
| ANDRE LAFLAMME3 Filed as: ANDRE LEON LAFLAMME | 9007 46TH COURT NORTHWEST GIG HARBOR, WA 98335 | CONTINENTAL AMERICAN INSURANCE COMPANY | $4 | — | $4 | 0.01% |
| SHEILA M LAFLAMME3 | 1426 EAST IRON EAGLE DRIVE EAGLE, ID 83616 | CONTINENTAL AMERICAN INSURANCE COMPANY | $4 | — | $4 | 0.01% |
| VINCENT BRIAN VOLLMAR3 Filed as: VINCENT B VOLLMAR | 3230 DOGWOOD DRIVE SOUTH SALEM, OR 97302 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3 | — | $3 | 0.01% |
| KIMBERLY A PARKS3 | 19818 NORTH 147TH DRIVE SUN CITY WEST, AZ 85375 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2 | — | $2 | 0.01% |
| RAYMON P KEECH III3 | 8207 CAMPAIGN CIRCLE RICHMOND, TX 77406 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2 | — | $2 | 0.01% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNEWEST INSURANCE | — | OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON | $391 | — | $391 | 1.25% |
| MARSH & MCLENNAN AGENCY LLC3 | — | OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON | $188 | — | $188 | 0.60% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 12748 ROANOKE, VA 24028 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 10.12% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNEWEST INSURANCE INC | 2925 PALMER STREET SUITE B MISSOULA, MT 59806 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | $438 | $2K | 6.52% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 12748 ROANOKE, VA 24028 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $788 | — | $788 | 10.10% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNEWEST INSURANCE INC | 2925 PALMER STREET SUITE B MISSOULA, MT 59806 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $382 | $129 | $511 | 6.55% |
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 | 111 | 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) | 111 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MODA HEALTH | 109 | $800K |
| Dental(2 contracts) | OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON | 57 | $70K |
| Vision | MODA HEALTH | 109 | $800K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 111 | $8K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 111 | $27K |
| Other(3 contracts, 3 carriers) | CONTINENTAL AMERICAN INSURANCE COMPANY | 186 | $46K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 186 | — |
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."
No prospect flags tripped on this filing.