| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DAVIDSON BENEFITS PLANNING LLC3 | 7632 DURHAM RD SUITE 115 TIGARD, OR 97224 | METROPOLITAN LIFE INSURANCE COMPANY | $9K | — | $9K | 1.42% |
| DAVIDSON BENEFITS PLANNING LLC3 | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | SUN LIFE ASSURANCE COMPANY OF CANADA | $31K | — | $31K | 5.00% |
| UNITED BENEFIT ADVISORS NW LLC3 | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | SUN LIFE ASSURANCE COMPANY OF CANADA | $15K | — | $15K | 2.50% |
| DAVIDSON BENEFITS PLANNING LLC3 | 7632 SW DURHAM RD SUITE 115 TIGARD, OR 97224 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $58K | $5K | $63K | 14.91% |
| DAVIDSON BENEFITS PLANNING LLC3 | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $17K | $1K | $19K | 14.93% |
| JAMES H. VAN EPPS3 Filed as: JAMES H VAN EPPS | 10930 CRABAPPLE RD STE 206 ROSWELL, GA 30075 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $15K | $4 | $15K | 20.23% |
| DAVIDSON BENEFITS PLANNING LLC3 | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $133 | $7K | 10.35% |
| CHARLES D. BLOCK3 Filed as: CHARLES D BLOCK | 648 VILLAGE PARK DR UNIT 208 WILMINGTON, NC 28405 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $451 | $5K | 6.53% |
| TRUSTNODE3 | 101 MONTGOMERY ST STE 350 SAN FRANCISCO, CA 94104 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $446 | — | $446 | 0.62% |
| CHARLES D. BLOCK3 Filed as: CHARLES D BLOCK | 648 VILLAGE PARK DR UNIT 208 WILMINGTON, NC 28405 | UNUM LIFE INSURANCE COMPANY OF AMERICA | -$16K | -$2K | -$18K | -24.48% |
| DAVIDSON BENEFITS PLANNING LLC3 | 7632 SW DURHAM RD SUITE 115 TIGARD, OR 97224 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $678 | $4K | 6.95% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTHCARE MANAGEMENT ADMIN, INC EIN 91-1333840 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $501K |
| DAVIDSON BENEFITS PLANNING LLC EIN 93-1263635 BROKER | Insurance agents and brokers Service code 22 | — | $137K |
| HR SIMPLIFIED INC EIN 41-1877873 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $22K |
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 | 1,041 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 48 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,097 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 1,814 | $627K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,023 | $185K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 266 | $422K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 266 | $422K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 843 | $612K |
| Other(4 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,025 | $283K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,814 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.