| 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 PLAN | $21K | $0 | $21K | 3.08% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $5K | $0 | $5K | 9.53% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $2K | $2K | 3.98% |
| 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% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 975 OAK STREET, SUITE 900 EUGENE, OR 97401 | VISION SERVICE PLAN | $451 | $0 | $451 | 3.24% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $361 | $0 | $361 | 2.59% |
| REBECCA L. HILL3 | 1980 HOLLY AVENUE EUGENE, OR 97408 | AFLAC | $978 | $62 | $1K | 7.76% |
| JEROMY E. CILLEY3 | 1115 PEARL STREET EUGENE, OR 97401 | AFLAC | $329 | $15 | $344 | 2.57% |
| DAVID N GUSTAFSON3 Filed as: DAVID JACKSON | 695 EAST 40TH AVENUE EUGENE, OR 97405 | AFLAC | $330 | $0 | $330 | 2.46% |
| MARCIE M. WACHAL AND OTHER AGENTS3 | 33636 PAIUTE LANE EUGENE, OR 97408 | AFLAC | $218 | $7 | $225 | 1.68% |
| RICHARD E. SYFERT3 | 86195 PANORAMA ROAD SPRINGFIELD, OR 97478 | AFLAC | $199 | $15 | $214 | 1.60% |
| BRADLEY R. SWANK3 | PO BOX 872 SPRINGFIELD, OR 97477 | AFLAC | $88 | $0 | $88 | 0.66% |
| GUY R SOUTER3 Filed as: GUY R. SOUTER | PO BOX 1283 LA PINE, OR 97739 | AFLAC | $72 | $0 | $72 | 0.54% |
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 | 101 | 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) | 101 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PROVIDENCE HEALTH PLAN | 122 | $687K |
| Dental(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 117 | $101K |
| Vision | VISION SERVICE PLAN | 150 | $14K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 93 | $53K |
| Prescription drug | PROVIDENCE HEALTH PLAN | 122 | $687K |
| Other(3 contracts, 3 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 751 | $78K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 751 | — |
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.