| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 975 OAK STREET, SUITE 900 EUGENE, OR 97401 | PROVIDENCE HEALTH PLANS | $27K | $0 | $27K | 3.20% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $7K | $0 | $7K | 9.14% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $6K | $6K | 7.80% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 975 OAK STREET, SUITE 900 EUGENE, OR 97401 | WILLAMETTE DENTAL INSURANCE, INC. | $2K | $0 | $2K | 5.00% |
| REBECCA L. HILL3 | 1980 HOLLY AVENUE EUGENE, OR 97408 | AFLAC | $2K | $0 | $2K | 12.37% |
| JEROMY E. CILLEY3 | 1115 PEARL STREET EUGENE, OR 97401 | AFLAC | $713 | $6 | $719 | 4.52% |
| RICHARD E. SYFERT3 | 86195 PANAORAMA ROAD SPRINGFIELD, OR 97478 | AFLAC | $276 | $6 | $282 | 1.77% |
| GUY R SOUTER3 Filed as: GUY R. SOUTER | 16280 PINE DROP LANE LA PINE, OR 97739 | AFLAC | $108 | $0 | $108 | 0.68% |
| MJ INSURANCE3 Filed as: SONJA R. TAYLOR AND VARIOUS AGENTS | 2350 OAKMONT WAY, SUITE 205 EUGENE, OR 97401 | AFLAC | $86 | $9 | $95 | 0.60% |
| JOHN CAMERON TAYLOR & OTHER AGENTS3 Filed as: JOHN CAMERON TAYLOR | 923 SHERWOOD PLACE EUGENE, OR 97401 | AFLAC | $72 | $20 | $92 | 0.58% |
| BRADLEY R. SWANK3 | PO BOX 872 SPRINGFIELD, OR 97477 | AFLAC | $37 | $0 | $37 | 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 | 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) | PROVIDENCE HEALTH PLANS | 144 | $844K |
| Dental(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 144 | $114K |
| Vision | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 144 | $72K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 144 | $72K |
| Prescription drug | PROVIDENCE HEALTH PLANS | 144 | $844K |
| Other(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 144 | $88K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 144 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.