| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 975 OAK STREET, SUITE 900 EUGENE, OR 97401 | PROVIDENCE HEALTH PLANS | $27K | $0 | $27K | 3.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $7K | $0 | $7K | 8.59% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $2K | $2K | 2.44% |
| USI INSURANCE SERVICES LLC3 | 975 OAK STREET, SUITE 900 EUGENE, OR 97401 | WILLAMETTE DENTAL INSURANCE, INC. | $3K | $0 | $3K | 5.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $1K | $0 | $1K | 5.79% |
| REBECCA L. HILL3 Filed as: REBECCA HILL | 1980 HOLLY AVENUE EUGENE, OR 97408 | AFLAC | $1K | $64 | $1K | 9.57% |
| RICHARD E. SYFERT3 Filed as: RICHARD SYFERT | PO BOX 917 PLEASANT HILL, OR 97455 | AFLAC | $249 | $15 | $264 | 1.94% |
| JEROMY E. CILLEY3 Filed as: JEROMY CILLEY | 2683 EAST WILSHIRE DRIVE EUGENE, OR 97405 | AFLAC | $236 | $0 | $236 | 1.73% |
| MJ INSURANCE3 Filed as: DAVID JACKSON AND VARIOUS AGENTS | 695 EAST 40TH AVENUE EUGENE, OR 97405 | AFLAC | $210 | $8 | $218 | 1.60% |
| VINCENT BRIAN VOLLMAR3 Filed as: VINCENT VOLLMAR | 777 COMMERCIAL STREET SE, SUITE 20 SALEM, OR 97301 | AFLAC | $103 | $7 | $110 | 0.81% |
| BRADLEY R. SWANK3 Filed as: BRADLEY SWANK | PO BOX 872 SPRINGFIELD, OR 97477 | AFLAC | $88 | $0 | $88 | 0.65% |
| GUY R SOUTER3 Filed as: GUY SOUTER | PO BOX 1283 LA PINE, OR 97739 | AFLAC | $63 | $0 | $63 | 0.46% |
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 | 635 | 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) | 635 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PROVIDENCE HEALTH PLANS | 138 | $902K |
| Dental(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 147 | $139K |
| Vision | VISION SERVICE PLAN | 174 | $18K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 141 | $80K |
| Prescription drug | PROVIDENCE HEALTH PLANS | 138 | $902K |
| Other(3 contracts, 3 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 635 | $104K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 635 | — |
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.