| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MJ INSURANCE3 Filed as: MJI, INC. | PO BOX 847 MCMINNVILLE, OR 97128 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $6K | $0 | $6K | 11.09% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 825 NE MULTNOMAH STREET, SUITE 1500 PORTLAND, OR 97232 | WILLAMETTE DENTAL INSURANCE, INC. | $1K | $0 | $1K | 5.23% |
| MJ INSURANCE3 Filed as: MJI, INC. | PO BOX 847 MCMINNVILLE, OR 97128 | VISION SERVICE PLAN | $433 | $0 | $433 | 6.31% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $128 | $0 | $128 | 1.87% |
| WILLIAM R MEDITZ3 Filed as: WILLIAM R. MEDITZ | 25884 SW CANYON CREEK ROAD APARTMENT J202 WILSONVILLE, OR 97070 | AFLAC | $92 | $0 | $92 | 2.10% |
| ALICIA J MATSON3 Filed as: ALICIA J. MATSON | 6027 ROLLETTI DRIVE SE SALEM, OR 97306 | AFLAC | $38 | $0 | $38 | 0.87% |
| THERESA GREEN3 | 426 GREENACRE DRIVE NW SALEM, OR 97304 | AFLAC | $34 | $0 | $34 | 0.78% |
| ANDRIA R. KINYON3 | 10990 WAYPARK DRIVE NE SALEM, OR 97305 | AFLAC | $25 | $0 | $25 | 0.57% |
| VINCENT BRIAN VOLLMAR3 | 777 COMMERCIAL STREET SE, SUITE 20 SALEM, OR 97301 | AFLAC | $13 | $0 | $13 | 0.30% |
| CHERYL L. BONNER3 | 2754 TANGENT WAY SE SALEM, OR 97317 | AFLAC | $10 | $0 | $10 | 0.23% |
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 | 230 | 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) | 230 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 131 | $75K |
| Vision | VISION SERVICE PLAN | 70 | $7K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 131 | $55K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 131 | $55K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 131 | $55K |
| Other(3 contracts, 3 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 230 | $63K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 230 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.