| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE INC | PO BOX 29 SPRINGFIELD, OR 94777 | PACIFICSOURCE HEALTH PLANS | $38K | $0 | $38K | 1.89% |
| KINGREY PRICE INC3 | PO BOX 784 SPRINGFIELD, OR 94777 | HARTFORD LIFE AND ACCIDENT | $6K | $0 | $6K | 6.84% |
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 | 209 | 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) | 209 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PACIFICSOURCE HEALTH PLANS | 345 | $2.0M |
| Dental | PACIFICSOURCE HEALTH PLANS | 345 | $2.0M |
| Vision | PACIFICSOURCE HEALTH PLANS | 345 | $2.0M |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 209 | $84K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 209 | $84K |
| Prescription drug | PACIFICSOURCE HEALTH PLANS | 345 | $2.0M |
| Other | HARTFORD LIFE AND ACCIDENT | 209 | $84K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 345 | — |
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.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.