| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE | PO BOX 29 SPRINGFIELD, OR 97477 | PROVIDENCE HEALTH PLAN | $25K | $0 | $25K | 2.74% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE | PO BOX 784 SPRINGFIELD, OR 97477 | PRINCIPAL LIFE INSURANCE COMPANY | $8K | $495 | $8K | 8.10% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE | PO BOX 784 SPRINGFIELD, OR 97477 | WILLAMETTE DENTAL INSURANCE, INC. | $756 | $0 | $756 | 3.98% |
| PHILIP GREGORY HETZ3 | 19871 PORCUPINE DRIVE BEND, OR 97702 | AFLAC | $537 | $91 | $628 | 4.81% |
| ALEX ISAAC PITCHER AND VAR. AGENTS3 | 424 NW COLUMBIA STREET BEND, OR 97703 | AFLAC | $473 | $0 | $473 | 3.62% |
| RYAN GEORGE KRUIT3 | 612 SE GLENEDEN PLACE BEND, OR 97702 | AFLAC | $413 | $0 | $413 | 3.16% |
| DOREEN HETZ0 Filed as: DOREEN W HETZ | 19871 PORCUPINE DRIVE BEND, OR 97702 | AFLAC | $295 | $0 | $295 | 2.26% |
| GUY R SOUTER3 | PO BOX 1283 16280 PINE DROP LANE LA PINE, OR 97739 | AFLAC | $208 | $37 | $245 | 1.88% |
| JEAN CONGLETON3 | 21143 BEE TREE LANE BEND, OR 97701 | AFLAC | $200 | $0 | $200 | 1.53% |
| RICHARD J ROSS3 | 2463 NE BUCKWHEAT COURT BEND, OR 97703 | AFLAC | $100 | $0 | $100 | 0.77% |
| JEAN CONGLETON3 | 21143 BEE TREE LANE BEND, OR 97701 | AFLAC | $224 | $0 | $224 | 2.75% |
| DOREEN HETZ3 Filed as: DOREEN W HETZ | 19871 PORCUPINE DRIVE BEND, OR 97702 | AFLAC | $168 | $0 | $168 | 2.06% |
| GUY R SOUTER3 | PO BOX 1283 16280 PINE DROP LANE LA PINE, OR 97739 | AFLAC | $131 | $0 | $131 | 1.61% |
| MJ INSURANCE3 Filed as: SCOTT E NIELSEN AND VARIOUS AGENTS | 718B WEST FOURTH PLAN BOULEVARD VANCOUVER, WA 98660 | AFLAC | $124 | $0 | $124 | 1.52% |
| PHILIP GREGORY HETZ3 | 19871 PORCUPINE DRIVE BEND, OR 97702 | AFLAC | $120 | $0 | $120 | 1.47% |
| CHARLES N. ENDICOTT3 Filed as: CHARLES N ENDICOTT | 1188 NE 27TH STREET, SUITE 46 BEND, OR 97701 | AFLAC | $113 | $0 | $113 | 1.39% |
| ROGER L OLSON3 | 471 DAVIS LAKE ROAD USK, WA 99180 | AFLAC | $54 | $0 | $54 | 0.66% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE | PO BOX 784 SPRINGFIELD, OR 97477 | BENEFIT INTELLIGENCE | $300 | $0 | $300 | 4.99% |
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 | 110 | 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) | 110 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | PROVIDENCE HEALTH PLAN | 168 | $910K |
| Dental(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 190 | $120K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 190 | $101K |
| Life insurance(3 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 190 | $122K |
| Short-term disability(2 contracts) | AFLAC | 17 | $21K |
| Prescription drug | PROVIDENCE HEALTH PLAN | 168 | $904K |
| Other(4 contracts, 3 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 190 | $128K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 190 | — |
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.