| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE INC | PO BOX 29 SPRINGFIELD, OR 97477 | PROVIDENCE HEALTH PLAN | $29K | $0 | $29K | 3.75% |
| PROPEL INSURANCE3 | PO BOX 936 MEDFORD, OR 97501 | PROVIDENCE HEALTH PLAN | $3K | $0 | $3K | 0.40% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE INC. | PO BOX 784 SPRINGFIELD, OR 97477 | PRINCIPAL LIFE INSURANCE COMPANY | $6K | $298 | $6K | 6.43% |
| BRATRUD MIDDLETON INSURANCE BROKERS3 | 1201 PACIFIC AVENUE, SUITE 1000 TACOMA, WA 98402 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | $0 | $1K | 1.15% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE, INC. | 1111 GATEWAY LOOP SPRINGFIELD, OR 97477 | WILLAMETTE DENTAL INSURANCE, INC. | $555 | $0 | $555 | 3.45% |
| PROPEL INSURANCE3 | UNKNOWN BEND, OR 97702 | WILLAMETTE DENTAL INSURANCE, INC. | $89 | $0 | $89 | 0.55% |
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 | 103 | 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) | 103 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PROVIDENCE HEALTH PLAN | 161 | $773K |
| Dental(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 181 | $111K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 181 | $95K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 181 | $95K |
| Prescription drug | PROVIDENCE HEALTH PLAN | 161 | $773K |
| Other | PRINCIPAL LIFE INSURANCE COMPANY | 181 | $95K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 181 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.