| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT WEEKS3 | 10260 SW GREENBUR ROAD SUITE 550 PORTLAND, OR 97223 | PROVIDENCE HEALTH PLAN | $46K | — | $46K | 10.04% |
| IMA, INC.3 | PO BOX 29 SPRINGFIELD, OR 97477 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $14K | $7K | $21K | 10.08% |
| WATCHTOWER BENEFITS, LLC3 | 2734 NORTH MILDRED AVENUE SUITE 3 CHICAGO, IL 60618 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 1.50% |
| KATE THOMAS GROUP INC3 Filed as: KATE THOMAS GROUP, INC. | 2660 NE HIGHWAY 20 SUITE 610332 BEND, OR 97701 | AFLAC | $5K | $184 | $5K | 26.86% |
| JAMES S SARANTIS3 Filed as: JAMES S. SARANTIS | 14132 SE FIRCREST COURT PORTLAND, OR 97236 | AFLAC | $665 | $33 | $698 | 3.60% |
| PHILIP GREGORY HETZ3 Filed as: PHILIP GREGORY HETZ AND OTHERS | 19871 PORCUPINE DRIVE BEND, OR 97702 | AFLAC | $189 | $0 | $189 | 0.97% |
| GREGORY SCOTT GANNON3 | 19639 EMERALD PLACE BEND, OR 97702 | AFLAC | $169 | $0 | $169 | 0.87% |
| RYAN GEORGE KRUIT3 | 612 SE GLENEDEN PLACE BEND, OR 97702 | AFLAC | $128 | $0 | $128 | 0.66% |
| RICHARD J ROSS3 Filed as: RICHARD J. ROSS | 1337 NE BARNEY STREET PRINEVILLE, OR 97754 | AFLAC | $40 | $0 | $40 | 0.21% |
| JAMES F TUOR3 Filed as: JAMES F. TUOR | 22416 NORTH ARRELLAGA DRIVE SUN CITY WEST, AZ 85375 | AFLAC | $40 | $0 | $40 | 0.21% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE | PO BOX 784 SPRINGFIELD, OR 97477 | MEDICAL AIR SERVICES ASSOCIATION, INC. | $2K | — | $2K | 9.89% |
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 | 189 | 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) | 189 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | PROVIDENCE HEALTH PLAN | 339 | $473K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 189 | $205K |
| Vision | PROVIDENCE HEALTH PLAN | 339 | $457K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 189 | $205K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 189 | $205K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 189 | $205K |
| Prescription drug(2 contracts, 2 carriers) | PROVIDENCE HEALTH PLAN | 339 | $473K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 189 | $224K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 339 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.