| 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 | $20K | $950 | $21K | 2.04% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE LLC | 1111 GATEWAY LOOP SPRINGFIELD, OR 97477 | PACIFICSOURCE HEALTH PLANS | $10K | $0 | $10K | 1.02% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE LLC | 1111 GATEWAY LOOP SPRINGFIELD, OR 97477 | PRINCIPAL LIFE INSURANCE COMPANY | $9K | $0 | $9K | 8.32% |
| RYAN GEORGE KRUIT3 Filed as: RYAN KRUIT | 612 SE GLENEDEN PLACE BEND, OR 97702 | AFLAC | $270 | $0 | $270 | 2.98% |
| DOREEN HETZ3 | 19871 PORCUPINE DRIVE BEND, OR 97702 | AFLAC | $227 | $0 | $227 | 2.51% |
| PHILIP GREGORY HETZ3 Filed as: PHILIP HETZ | 19871 PORCUPINE DRIVE BEND, OR 97702 | AFLAC | $220 | $0 | $220 | 2.43% |
| MJ INSURANCE3 Filed as: SCOTT NIELSEN AND VARIOUS AGENTS | 718B WEST FOURTH PLAIN BOULEVARD VANCOUVER, WA 98660 | AFLAC | $187 | $0 | $187 | 2.07% |
| JEAN CONGLETON3 | 21143 BEE TREE LANE BEND, OR 97701 | AFLAC | $136 | $0 | $136 | 1.50% |
| RICHARD J ROSS3 Filed as: RICHARD ROSS | 1337 NE BARNEY STREET PRINEVILLE, OR 97754 | AFLAC | $82 | $0 | $82 | 0.91% |
| DIXIE D SIMON3 Filed as: DIXIE SIMON | 509 NORTH SHAMROCK ROAD SPOKANE VALLEY, WA 99037 | AFLAC | $69 | $0 | $69 | 0.76% |
| RYAN GEORGE KRUIT3 Filed as: RYAN KRUIT | 612 SE GLENEDEN PLACE BEND, OR 97702 | AFLAC | $304 | $16 | $320 | 3.73% |
| MJ INSURANCE3 Filed as: ROGER OLSON AND VARIOUS AGENTS | 471 DAVIS LAKE ROAD USK, WA 99180 | AFLAC | $179 | $4 | $183 | 2.13% |
| DOREEN HETZ3 | 19871 PORCUPINE DRIVE BEND, OR 97702 | AFLAC | $150 | $0 | $150 | 1.75% |
| JEAN CONGLETON3 | 21143 BEE TREE LANE BEND, OR 97701 | AFLAC | $143 | $0 | $143 | 1.67% |
| PHILIP GREGORY HETZ3 Filed as: PHILIP HETZ | 19871 PORCUPINE DRIVE BEND, OR 97702 | AFLAC | $125 | $0 | $125 | 1.46% |
| GUY R SOUTER3 Filed as: GUY SOUTER | 1930 VILLAGE CENTER CIRCLE, SUITE 3 LAS VEGAS, NV 89134 | AFLAC | $120 | $0 | $120 | 1.40% |
| CHARLES N. ENDICOTT3 Filed as: CHARLES ENDICOTT | 1188 NE 27TH STREET, UNIT 46 BEND, OR 97701 | AFLAC | $68 | $0 | $68 | 0.79% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE LLC | 1111 GATEWAY LOOP SPRINGFIELD, OR 97477 | TELEDOC | $135 | $0 | $135 | 2.41% |
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 | 102 | 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) | 102 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | PACIFICSOURCE HEALTH PLANS | 193 | $1.0M |
| Dental(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 190 | $128K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 190 | $106K |
| Life insurance(3 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 190 | $123K |
| Short-term disability(2 contracts) | AFLAC | 13 | $18K |
| Prescription drug | PACIFICSOURCE HEALTH PLANS | 146 | $1.0M |
| Other(4 contracts, 3 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 190 | $129K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 193 | — |
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.