| 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 | $24K | $0 | $24K | 2.74% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $5K | $0 | $5K | 8.83% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 975 OAK STREET, SUITE 900 EUGENE, OR 97401 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $3K | $3K | 4.39% |
| 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 | $52 | $2K | 10.45% |
| JEROMY E. CILLEY3 | 1115 PEARL STREET EUGENE, OR 97401 | AFLAC | $707 | $10 | $717 | 3.56% |
| RICHARD E. SYFERT3 | 86195 PANORAMA ROAD SPRINGFIELD, OR 97478 | AFLAC | $361 | $10 | $371 | 1.84% |
| MARCIE M. WACHAL AND OTHER AGENTS3 Filed as: MARCIE MARCEL WACHAL | 33636 PAIUTE LANE EUGENE, OR 97408 | AFLAC | $173 | $0 | $173 | 0.86% |
| JOHN CAMERON TAYLOR & OTHER AGENTS3 Filed as: JOHN C. TAYLOR AND OTHER AGENTS | 923 SHERWOOD PLACE EUGENE, OR 97401 | AFLAC | $149 | $0 | $149 | 0.74% |
| GUY R SOUTER3 Filed as: GUY R. SOUTER | PO BOX 1283 LA PINE, OR 97739 | AFLAC | $123 | $0 | $123 | 0.61% |
| BRADLEY R. SWANK3 | PO BOX 872 SPRINGFIELD, OR 97477 | AFLAC | $88 | $0 | $88 | 0.44% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 975 OAK STREET, SUITE 900 EUGENE, OR 97401 | VISION SERVICE PLAN | $965 | $0 | $965 | 6.03% |
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 | 113 | 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) | 113 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PROVIDENCE HEALTH PLANS | 153 | $885K |
| Dental(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 123 | $108K |
| Vision | VISION SERVICE PLAN | 165 | $16K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 119 | $59K |
| Prescription drug | PROVIDENCE HEALTH PLANS | 153 | $885K |
| Other(3 contracts, 3 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 750 | $89K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 750 | — |
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.