| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE LLC | 1111 GATEWAY LOOP SPRINGFIELD, OR 97477 | PACIFICSOURCE HEALTH PLANS | $34K | $0 | $34K | 3.23% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE LLC | 1111 GATEWAY LOOP SPRINGFIELD, OR 97477 | PRINCIPAL LIFE INSURANCE COMPANY | $9K | $2K | $11K | 10.24% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE LLC | 1111 GATEWAY LOOP SPRINGFIELD, OR 97477 | WILLAMETTE DENTAL INSURANCE, INC. | $731 | $0 | $731 | 4.03% |
| PHILIP GREGORY HETZ3 Filed as: PHILIP HETZ | 19871 PORCUPINE DRIVE BEND, OR 97702 | AFLAC | $209 | $0 | $209 | 2.76% |
| DOREEN HETZ3 | 19871 PORCUPINE DRIVE BEND, OR 97702 | AFLAC | $183 | $0 | $183 | 2.41% |
| MJ INSURANCE3 Filed as: SCOTT NIELSEN AND VARIOUS AGENTS | 7188 WEST FOURTH PLAIN BOULEVARD VANCOUVER, WA 98660 | AFLAC | $170 | $0 | $170 | 2.24% |
| RYAN GEORGE KRUIT3 Filed as: RYAN KRUIT | 612 SE GLENEDEN PLACE BEND, OR 97702 | AFLAC | $164 | $0 | $164 | 2.16% |
| JEAN CONGLETON3 | 21143 BEE TREE LANE BEND, OR 97701 | AFLAC | $136 | $0 | $136 | 1.79% |
| DIXIE D SIMON3 Filed as: DIXIE SIMON | 509 NORTH SHAMROCK ROAD SPOKANE VALLEY, WA 99037 | AFLAC | $69 | $0 | $69 | 0.91% |
| RICHARD J ROSS3 Filed as: RICHARD ROSS | 1337 NE BARNEY STREET PRINEVILLE, OR 97754 | AFLAC | $58 | $0 | $58 | 0.77% |
| MJ INSURANCE3 Filed as: ROGER OLSON AND VARIOUS AGENTS | 12105 EAST VIA LOMA VISTA YUMA, AZ 85367 | AFLAC | $162 | $0 | $162 | 2.27% |
| RYAN GEORGE KRUIT3 Filed as: RYAN KRUIT | 612 SE GLENEDEN PLACE BEND, OR 97702 | AFLAC | $146 | $0 | $146 | 2.04% |
| JEAN CONGLETON3 | 21143 BEE TREE LANE BEND, OR 97701 | AFLAC | $143 | $0 | $143 | 2.00% |
| DOREEN HETZ3 | 19871 PORCUPINE DRIVE BEND, OR 97702 | AFLAC | $143 | $0 | $143 | 2.00% |
| CHARLES N. ENDICOTT3 Filed as: CHARLES ENDICOTT | 1188 NE 27TH STREET, UNIT 46 BEND, OR 97701 | AFLAC | $68 | $0 | $68 | 0.95% |
| GUYSOUTER3 | 1930 VILLAGE CENTER CIRCLE, SUITE 3 LAS VEGAS, NV 89134 | AFLAC | $57 | $0 | $57 | 0.80% |
| PHILIP GREGORY HETZ3 Filed as: PHILIP HETZ | 19871 PORCUPINE DRIVE BEND, OR 97702 | AFLAC | $54 | $0 | $54 | 0.76% |
| UNKNOWN3 | UNKNOWN BEND, OR 97702 | TELEDOC | $256 | $0 | $256 | 11.39% |
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 | 97 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 98 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | PACIFICSOURCE HEALTH PLANS | 171 | $1.0M |
| Dental(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 177 | $126K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 177 | $108K |
| Life insurance(3 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 177 | $123K |
| Short-term disability(2 contracts) | AFLAC | 11 | $15K |
| Prescription drug | PACIFICSOURCE HEALTH PLANS | 138 | $1.0M |
| Other(4 contracts, 3 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 177 | $125K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 177 | — |
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.