| 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 | $23K | $798 | $24K | 2.10% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE INC | PO BOX 784 SPRINGFIELD, OR 97477 | OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON | $2K | $0 | $2K | 2.99% |
| MARCI MARIE OTIS3 | 200 JULINA LANE ROSEBURG, OR 97471 | AFLAC | $3K | $55 | $3K | 7.54% |
| CAROL A. KENYON3 | 1645 CLEVELAND HILL ROAD ROSEBURG, OR 97471 | AFLAC | $2K | $55 | $2K | 5.52% |
| JOSEPH FIDDY INC3 Filed as: JOSEPH FIDDY INC. | 2000 WEST HARVARD AVENUE, SUITE 100 ROSEBURG, OR 97471 | AFLAC | $658 | $0 | $658 | 1.82% |
| MJ INSURANCE3 Filed as: JEROMY E. CILLEY AND VARIOUS AGENTS | 2683 EAST WILSHIRE DRIVE EUGENE, OR 97405 | AFLAC | $541 | $26 | $567 | 1.57% |
| VINCENT BRIAN VOLLMAR3 | 777 COMMERCIAL STREET SE, SUITE 20 SALEM, OR 97301 | AFLAC | $300 | $26 | $326 | 0.90% |
| NOAH BAILEY3 | 201 WEST MAIN STREET, SUITE 4A MEDFORD, OR 97501 | AFLAC | $158 | $0 | $158 | 0.44% |
| RICHARD E. SYFERT3 | PO BOX 917 PLEASANT HILL, OR 97455 | AFLAC | $83 | $0 | $83 | 0.23% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE INC | 1111 GATEWAY LOOP SPRINGFIELD, OR 97477 | WILLAMETTE DENTAL INSURANCE, INC. | $935 | $0 | $935 | 5.00% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE INC | PO BOX 784 SPRINGFIELD, OR 97477 | VISION SERVICE PLAN | $1K | $0 | $1K | 9.11% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE INC | 1111 GATEWAY LOOP SPRINGFIELD, OR 97477 | STANDARD INSURANCE COMPANY | $1K | $0 | $1K | 9.54% |
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 | 206 | $1.1M |
| Dental(3 contracts, 3 carriers) | OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON | 234 | $112K |
| Vision(2 contracts, 2 carriers) | AFLAC | 76 | $48K |
| Life insurance(2 contracts, 2 carriers) | AFLAC | 113 | $48K |
| Short-term disability | AFLAC | 55 | $36K |
| Prescription drug | REGENCE BLUECROSS BLUESHIELD OF OREGON | 206 | $1.1M |
| Other(2 contracts, 2 carriers) | AFLAC | 113 | $48K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 234 | — |
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.