| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE LLC | PO BOX 784 SPRINGFIELD, OR 97477 | PROVIDENCE HEALTH PLAN | $53K | $0 | $53K | 3.00% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE LLC | PO BOX 784 SPRINGFIELD, OR 97477 | LIFEMAP ASSURANCE COMPANY | $13K | $0 | $13K | 7.41% |
| KATE THOMAS GROUP INC3 | PO BOX 8712 BEND, OR 97708 | AFLAC | $1K | $0 | $1K | 10.17% |
| RYAN GEORGE KRUIT3 Filed as: RYAN KRUIT | 612 SE GLENEDEN PLACE BEND, OR 97702 | AFLAC | $1K | $0 | $1K | 9.65% |
| MJ INSURANCE3 Filed as: SCOTT STORJOHANN AND VARIOUS AGENTS | 10110 EATON STREET WESTMINSTER, CO 80020 | AFLAC | $349 | $0 | $349 | 3.12% |
| JAMES S SARANTIS3 Filed as: JAMES SARANTIS | 14132 SE FIRCREST COURT PORTLAND, OR 97236 | AFLAC | $322 | $0 | $322 | 2.88% |
| JANALE MOORE3 | 2317 NE COLLEEN ALLEY PRINEVILLE, OR 97754 | AFLAC | $319 | $0 | $319 | 2.85% |
| GREGORY SCOTT GANNON3 Filed as: GREGORY GANNON | 19639 EMERALD PLACE BEND, OR 97702 | AFLAC | $183 | $0 | $183 | 1.64% |
| PHILLIP GREGORY HETZ3 Filed as: PHILLIP HETZ | 19871 PORCUPINE DRIVE BEND, OR 97702 | AFLAC | $145 | $0 | $145 | 1.30% |
| MASA AGENTS3 | UNKNOWN BEND, OR 97701 | MEDICAL AIR SERVICES ASSOCIATION, INC. | $733 | $0 | $733 | 6.66% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE LLC | PO BOX 784 SPRINGFIELD, OR 97477 | MEDICAL AIR SERVICES ASSOCIATION, INC. | $709 | $0 | $709 | 6.44% |
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 | 120 | 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) | 120 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | PROVIDENCE HEALTH PLAN | 270 | $1.8M |
| Dental | LIFEMAP ASSURANCE COMPANY | 137 | $173K |
| Vision | PROVIDENCE HEALTH PLAN | 270 | $1.8M |
| Life insurance | LIFEMAP ASSURANCE COMPANY | 137 | $173K |
| Short-term disability | LIFEMAP ASSURANCE COMPANY | 137 | $173K |
| Long-term disability | LIFEMAP ASSURANCE COMPANY | 137 | $173K |
| Prescription drug | PROVIDENCE HEALTH PLAN | 270 | $1.8M |
| Other(2 contracts, 2 carriers) | LIFEMAP ASSURANCE COMPANY | 137 | $185K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 270 | — |
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.