| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE INC | PO BOX 29 SPRINGFIELD, OR 97477 | REGENCE BLUECROSS BLUESHIELD OF OREGON | $25K | $833 | $26K | 1.99% |
| MARCI MARIE OTIS3 | 200 JULINA LANE ROSEBURG, OR 97471 | AFLAC | $2K | $10 | $2K | 4.39% |
| CAROL A. KENYON3 | 1645 CLEVELAND HILL ROAD ROSEBURG, OR 97471 | AFLAC | $1K | $17 | $1K | 2.76% |
| JOSEPH FIDDY INC3 | 2000 WEST HARVARD AVENUE, SUITE 100 ROSEBURG, OR 97471 | AFLAC | $1K | $0 | $1K | 2.74% |
| MJ INSURANCE3 Filed as: SCOTT E. NIELSEN AND VARIOUS AGENTS | 718B WEST FOURTH PLAIN BOULEVARD VANCOUVER, WA 98660 | AFLAC | $654 | $13 | $667 | 1.72% |
| JEROME E. CILLEY3 | 1115 PEARL STREET EUGENE, OR 97401 | AFLAC | $305 | $7 | $312 | 0.80% |
| GUY R SOUTER3 Filed as: GUY R. SOUTER | PO BOX 1283 LA PINE, OR 97739 | AFLAC | $113 | $0 | $113 | 0.29% |
| KIMBERLY D. ADAMS3 | PO BOX 167 UMPQUA, OR 97486 | AFLAC | $76 | $0 | $76 | 0.20% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE INC | PO BOX 784 SPRINGFIELD, OR 97477 | WILLAMETTE DENTAL INSURANCE, INC. | $2K | $0 | $2K | 5.00% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE INC | PO BOX 784 SPRINGFIELD, OR 97477 | STANDARD INSURANCE COMPANY | $2K | $387 | $2K | 10.42% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE INC | PO BOX 784 SPRINGFIELD, OR 97477 | VISION SERVICE PLAN | $833 | $0 | $833 | 6.78% |
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 | 126 | 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) | 126 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | REGENCE BLUECROSS BLUESHIELD OF OREGON | 215 | $1.3M |
| Dental(2 contracts, 2 carriers) | AFLAC | 142 | $77K |
| Vision(2 contracts, 2 carriers) | AFLAC | 81 | $51K |
| Life insurance(2 contracts, 2 carriers) | AFLAC | 126 | $59K |
| Short-term disability | AFLAC | 59 | $39K |
| Prescription drug | REGENCE BLUECROSS BLUESHIELD OF OREGON | 215 | $1.3M |
| Other(2 contracts, 2 carriers) | AFLAC | 126 | $59K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 215 | — |
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.