| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE INC | PO BOX 29 SPRINGFIELD, OR 97477 | PACIFICSOURCE HEALTH PLANS | $28K | $0 | $28K | 3.03% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE INC | PO BOX 784 SPRINGFIELD, OR 97477 | PRINCIPAL LIFE INSURANCE COMPANY | $8K | $2K | $10K | 11.05% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE INC | 1111 GATEWAY LOOP SPRINGFIELD, OR 97477 | PRINCIPAL LIFE INSURANCE COMPANY | $5 | $0 | $5 | 0.01% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE INC | 1111 GATEWAY LOOP SPRINGFIELD, OR 97477 | WILLAMETTE DENTAL INSURANCE, INC. | $980 | $0 | $980 | 4.00% |
| DOREEN HETZ3 | 19871 PORCUPINE DRIVE BEND, OR 97702 | AFLAC | $269 | $0 | $269 | 2.70% |
| PHILLIP GREGORY HETZ3 | 19871 PORCUPINE DRIVE BEND, OR 97702 | AFLAC | $230 | $0 | $230 | 2.30% |
| MJ INSURANCE3 Filed as: GUY R. SOUTER AND VARIOUS AGENTS | PO BOX 1283 LA PINE, OR 97739 | AFLAC | $205 | $0 | $205 | 2.05% |
| RYAN GEORGE KRUIT3 | 612 SE GLENEDEN PLACE BEND, OR 97702 | AFLAC | $196 | $0 | $196 | 1.96% |
| JEAN CONGLETON3 | 21143 BEE TREE LANE BEND, OR 97701 | AFLAC | $136 | $0 | $136 | 1.36% |
| RICHARD J ROSS3 Filed as: RICHARD J. ROSS | 1337 NE BARNEY STREET PRINEVILLE, OR 97754 | AFLAC | $82 | $0 | $82 | 0.82% |
| DIXIE D SIMON3 Filed as: DIXIE D. SIMON | 509 NORTH SHAMROCK ROAD SPOKANE VALLEY, WA 99037 | AFLAC | $69 | $0 | $69 | 0.69% |
| JEAN CONGLETON3 | 21143 BEE TREE LANE BEND, OR 97701 | AFLAC | $191 | $0 | $191 | 2.17% |
| MJ INSURANCE3 Filed as: ROGER OLSON AND VARIOUS AGENTS | 471 DAVIS LAKE ROAD USK, WA 99180 | AFLAC | $177 | $0 | $177 | 2.01% |
| DOREEN HETZ3 | 19871 PORCUPINE DRIVE BEND, OR 97702 | AFLAC | $150 | $0 | $150 | 1.70% |
| PHILLIP GREGORY HETZ3 | 19871 PORCUPINE DRIVE BEND, OR 97702 | AFLAC | $125 | $0 | $125 | 1.42% |
| GUY R SOUTER3 Filed as: GUY R. SOUTER | PO BOX 1283 LA PINE, OR 97739 | AFLAC | $120 | $0 | $120 | 1.36% |
| RYAN GEORGE KRUIT3 | 612 SE GLENEDEN PLACE BEND, OR 97702 | AFLAC | $114 | $0 | $114 | 1.29% |
| CHARLES N. ENDICOTT3 | 1188 NE 27TH STREET, UNIT 46 BEND, OR 97701 | AFLAC | $95 | $0 | $95 | 1.08% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE INC | PO BOX 29 SPRINGFIELD, OR 97477 | TELEDOC | $398 | $0 | $398 | 6.70% |
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 | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 97 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | PACIFICSOURCE HEALTH PLANS | 172 | $916K |
| Dental(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 183 | $117K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 183 | $92K |
| Life insurance(3 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 183 | $111K |
| Short-term disability(2 contracts) | AFLAC | 13 | $19K |
| Prescription drug | PACIFICSOURCE HEALTH PLANS | 148 | $910K |
| Other(4 contracts, 3 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 183 | $117K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 183 | — |
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.