| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WHA INSURANCE AGENCY INC3 | 2930 CHAD DR STE 100 EUGENE, OR 97408 | MODA HEALTH PLAN, INC | $16K | — | $16K | 1.83% |
| WHA INSURANCE AGENCY INC3 | 2930 CHAD DR STE 100 EUGENE, OR 974087382 | OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON | $2K | — | $2K | 4.27% |
| KELLY BEHR HOWLAND3 | 2828 DEBBIE DR KLAMATH FALLS, OR 97601 | AFLAC | $2K | $151 | $2K | 4.41% |
| FRED W KOEHLER JR3 | 1003 BISMARK KLAMATH FALLS, OR 97601 | AFLAC | $657 | — | $657 | 1.53% |
| KEEFE BURCHER3 Filed as: KEEFE B BURCHER | 201 W MAIN ST STE 4A MEDFORD, OR 97501 | AFLAC | $566 | $40 | $606 | 1.41% |
| DEREK RENDER3 | 1318 JOHNSON AVE KLAMATH FALLS, OR 97601 | AFLAC | $537 | $40 | $577 | 1.34% |
| LORI ANN PORTER3 | 2718 DEBBIE DRIVE KLAMATH FALLS, OR 97601 | AFLAC | $461 | $48 | $509 | 1.18% |
| NOLA EVANS INC3 | 10853 S RIDGE TOP DR MOLALLA, OR 97038 | AFLAC | $206 | — | $206 | 0.48% |
| ROGER L OLSON3 | 471 DAVIS LAKE ROAD USK, WA 99180 | AFLAC | $189 | — | $189 | 0.44% |
| DIXIE D SIMON3 | 509 N SHAMROCK RD SPOKANE VALLEY, WA 99037 | AFLAC | $187 | — | $187 | 0.43% |
| SCOTT NIELSEN3 | 718B FOURTH PLAIN BLVD VANCOUVER, WA 98660 | AFLAC | $103 | — | $103 | 0.24% |
| HAL HARRISON3 | 870 W CALLE DE EMILIA GREEN VALLEY, AZ 85614 | AFLAC | $69 | — | $69 | 0.16% |
| RICHARD J ROSS3 | 2463 NE BUCKWHEAT CT BEND, OR 97701 | AFLAC | $53 | — | $53 | 0.12% |
| ANDRE LAFLAMME3 | 9007 46TH COURT NW GIG HARBOR, WA 98335 | AFLAC | $51 | — | $51 | 0.12% |
| FORREST LEAL3 | PO BOX 185 LIMA, MT 59739 | AFLAC | $47 | — | $47 | 0.11% |
| ERNEST E SNOOK3 Filed as: ERNEST SNOOK | 14011 282ND LN NE DUVALL, WA 98019 | AFLAC | $38 | — | $38 | 0.09% |
| PATRICIA J GEE3 | PO BOX 2334 MESA, AZ 85214 | AFLAC | $36 | — | $36 | 0.08% |
| RODERICK ALLEN BAIR3 | 2900 N GOVERNMENT WAY 19 COEUR D ALENE, ID 83815 | AFLAC | $25 | — | $25 | 0.06% |
| SCOTT NIELSEN | 2709 DAY ISLAND BLVD W UNIT A UNIVERSITY PL, WA 98466 | AFLAC | $22 | — | $22 | 0.05% |
| NOLA EVANS INC | 10853 S RIDGE TOP DR CANBY, OR 97013 | AFLAC | $21 | — | $21 | 0.05% |
| RODERICK ALLEN BAIR | 8827 N GOVERNMENT WAY UNIT 105 HAYDEN, ID 83835 | AFLAC | $21 | — | $21 | 0.05% |
| RAYMON P KEECH III3 | 8207 CAMPAIGN CIR RICHMOND, TX 77406 | AFLAC | $21 | — | $21 | 0.05% |
| WHA INSURANCE AGENCY INC3 | 2930 CHAD DR EUGENE, OR 97408 | AFLAC | $16 | — | $16 | 0.04% |
| SHANE EDMUND ATTEBERY3 | 391 RANDY DR GRANTS PASS, OR 97527 | AFLAC | $12 | — | $12 | 0.03% |
| BRADLEY E BAILEY3 | PO BOX 125 LIBERTY LAKE, WA 99019 | AFLAC | $8 | — | $8 | 0.02% |
| KIMBERLY A PARKS3 | 19818 N 147TH DR SUN CITY WEST, AZ 85375 | AFLAC | $8 | — | $8 | 0.02% |
| ERIC DANIEL WEILAND3 | 14511 SW CORNERSTONE LN SHERWOOD, OR 97140 | AFLAC | $6 | — | $6 | 0.01% |
| GINA SIENIA3 | PO BOX 446 ECHO, OR 97826 | AFLAC | $6 | — | $6 | 0.01% |
| PHILLIP GOODRUM3 Filed as: PHILLIP ALLAN PAGE | 8870 SOUTH 500 EAST HUNTSVILLE, UT 84317 | AFLAC | $6 | — | $6 | 0.01% |
| PAUL MICHAEL HANNANT3 | 6052 SAWGRASS ST SE SALEM, OR 97306 | AFLAC | $3 | — | $3 | 0.01% |
| IOANNIS T GRATSINOPOULOS3 | 3565 SUMMERLINN DR WEST LINN, OR 97068 | AFLAC | $3 | — | $3 | 0.01% |
| MATTHEW G BERGER3 Filed as: MATTHEW SHROYER | 1384 NE 70TH AVE PORTLAND, OR 97213 | AFLAC | $2 | — | $2 | 0.00% |
| IOANNIS T GRATSINOPOULOS | 1893 E DAULBY ST MERIDIAN, ID 83642 | AFLAC | $2 | — | $2 | 0.00% |
| MARCI MARIE OTIS3 | 200 JULINA LN ROSEBURG, OR 97471 | AFLAC | $1 | — | $1 | 0.00% |
| MICHAEL C WALKER3 Filed as: MICHAEL M STASTNY | 605 PORTLAND AVE UNIT 531 GLADSTONE, OR 97027 | AFLAC | $1 | — | $1 | 0.00% |
| MJ INSURANCE3 Filed as: ROBIN D HUDSON | 15000 DAVIS LN APT 80 LAKE OSWEGO, OR 97035 | AFLAC | $1 | — | $1 | 0.00% |
| WHA INSURANCE AGENCY INC3 Filed as: WHA INSURANCE AGENCY, INC. | 2930 CHAD DR STE 100 EUGENE, OR 974087382 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
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. |
| Total participants (= "Plan participants" tile) | 126 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | MODA HEALTH PLAN, INC | 126 | $937K |
| Dental | OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON | 125 | $54K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 117 | $11K |
| Prescription drug(2 contracts, 2 carriers) | MODA HEALTH PLAN, INC | 126 | $937K |
| Stop-loss / reinsurancereinsurance | MODA HEALTH PLAN, INC | 126 | $894K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 126 | — |
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.