| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE INC | PO BOX 784 SPRINGFIELD, OR 97477 | REGENCE BLUECROSS BLUESHIELD OF OREGON | $25K | $0 | $25K | 2.07% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE INC | PO BOX 784 SPRINGFIELD, OR 97477 | WILLAMETTE DENTAL INSURANCE, INC. | $2K | $0 | $2K | 5.00% |
| MARCI MARIE OTIS3 | 200 JULINA LANE ROSEBURG, OR 97471 | AFLAC | $1K | $53 | $1K | 3.14% |
| JOSEPH FIDDY INC3 | 2000 WEST HARVARD AVENUE SUITE 100 ROSEBURG, OR 97471 | AFLAC | $911 | $0 | $911 | 2.58% |
| CAROL A. KENYON3 | 1645 CLEVELAND HILL ROAD ROSEBURG, OR 97471 | AFLAC | $492 | $53 | $545 | 1.54% |
| MJ INSURANCE3 Filed as: SHAWN OTIS AND VARIOUS AGENTS | 200 JULINA LANE ROSEBURG, OR 97471 | AFLAC | $514 | $0 | $514 | 1.46% |
| JEROMY E. CILLEY3 | 2683 EAST WILSHIRE DRIVE EUGENE, OR 97405 | AFLAC | $174 | $21 | $195 | 0.55% |
| KIMBERLY D. ADAMS3 | PO BOX 167 UMPQUA, OR 97486 | AFLAC | $121 | $0 | $121 | 0.34% |
| GARY R. SOUTER3 | PO BOX 1283 LA PINE, OR 97739 | AFLAC | $104 | $0 | $104 | 0.29% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE INC | PO BOX 784 SPRINGFIELD, OR 97477 | STANDARD INSURANCE COMPANY | $2K | $470 | $2K | 10.68% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE INC | 1111 GATEWAY LOOP SPRINGFIELD, OR 97477 | STANDARD INSURANCE COMPANY | $101 | $0 | $101 | 0.54% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE INC | PO BOX 784 SPRINGFIELD, OR 97477 | VISION SERVICE PLAN | $832 | $0 | $832 | 6.76% |
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 | 116 | 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) | 116 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | REGENCE BLUECROSS BLUESHIELD OF OREGON | 210 | $1.2M |
| Dental(2 contracts, 2 carriers) | WILLAMETTE DENTAL INSURANCE, INC. | 135 | $75K |
| Vision(2 contracts, 2 carriers) | AFLAC | 77 | $48K |
| Life insurance(2 contracts, 2 carriers) | AFLAC | 116 | $54K |
| Short-term disability | AFLAC | 59 | $35K |
| Prescription drug | REGENCE BLUECROSS BLUESHIELD OF OREGON | 210 | $1.2M |
| Other(2 contracts, 2 carriers) | AFLAC | 116 | $54K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 210 | — |
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.