| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX 3018 BOTHELL, WA 98041 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $8K | $8K | 2.44% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL NORTHWEST LLC | PO BOX 3018 BOTHELL, WA 98041 | UNUM INSURANCE COMPANY | $0 | $506 | $506 | 0.84% |
| JOSEPH FIDDY INC3 | 2000 WEST HARVARD AVENUE, SUITE 100 ROSEBURG, OR 97471 | AFLAC | $4K | $85 | $4K | 12.11% |
| NOAH BAILEY3 | 201 WEST MAIN STREET, SUITE 4A MEDFORD, OR 97501 | AFLAC | $798 | $17 | $815 | 2.70% |
| RICHARD E. SYFERT3 | PO BOX 917 PLEASANT HILL, OR 97455 | AFLAC | $673 | $0 | $673 | 2.23% |
| VINCENT BRIAN VOLLMAR3 | 4085 HAGER STREET SE, SUITE 300 SALEM, OR 97317 | AFLAC | $151 | $0 | $151 | 0.50% |
| JEROMY E. CILLEY3 Filed as: JEROMY E CILLEY | 2683 EAST WILSHIRE DRIVE EUGENE, OR 97405 | AFLAC | $124 | $0 | $124 | 0.41% |
| SCOTT NIELSEN3 Filed as: SCOTT E NIELSON AND OTHER AGENTS | 718B WEST FOURTH PLAIN BOULEVARD VANCOUVER, WA 98660 | AFLAC | $109 | $0 | $109 | 0.36% |
| MARCI MARIE OTIS3 | 200 JULINA LANE ROSEBURG, OR 97471 | AFLAC | $22 | $0 | $22 | 0.07% |
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 | 664 | 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) | 664 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 635 | $330K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 635 | $330K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 635 | $330K |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 635 | $421K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 635 | — |
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."
No prospect flags tripped on this filing.