| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DAVIDSON BENEFITS PLANNING LLC3 Filed as: DAVIDSON BENEFITS PLANNING, LLC. | 7632 SW DURHAM ROAD SUITE 115 TIGARD, OR 97224 | MODA HEALTH | $5K | $0 | $5K | 3.02% |
| DAVIDSON BENEFITS PLANNING LLC3 Filed as: DAVIDSON BENEFITS PLANNING, LLC. | 7632 SW DURHAM ROAD SUITE 115 TIGARD, OR 97224 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $2K | $0 | $2K | 3.00% |
| HEARTSEASE LLC3 Filed as: HEARTSEASE, LLC. | 1521 NE 63RD AVENUE HILLSBORO, OR 97124 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $2K | $4K | 15.74% |
| WORKSITE BENEFITS GROUP INC3 Filed as: WORKSITE BENEFITS GROUP, INC. | 112 NW 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $594 | $1K | $2K | 8.00% |
| DAVIDSON BENEFITS PLANNING LLC3 Filed as: DAVIDSON BENEFITS PLANNING, LLC. | 7632 SW DURHAM ROAD SUITE 115 TIGARD, OR 97224 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 7.85% |
| BENEFITS BY DESIGN INC3 Filed as: BENEFITS BY DESIGN, INC. | 2101 NE 279TH STREET RIDGEFIELD, WA 98642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $848 | $382 | $1K | 4.84% |
| SUSAN J LEACH3 Filed as: SUSAN J. LEACH | 4419 NE 131ST PLACE APARTMENT C1 PORTLAND, OR 97230 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $823 | $56 | $879 | 3.46% |
| TRICIA MILLER3 Filed as: TRICIA MILLER AND OTHER AGENTS | 2101 NE 279TH STREET RIDGEFIELD, WA 98642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $821 | $42 | $863 | 3.40% |
| MELISSA CATHLEEN HADLOCK3 | 14912 NE 249TH STREET BATTLE GROUND, WA 98604 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $651 | $25 | $676 | 2.66% |
| DAVIDSON BENEFITS PLANNING LLC3 Filed as: DAVIDSON BENEFITS PLANNING, LLC. | 7632 SW DURHAM ROAD SUITE 115 TIGARD, OR 97224 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $522 | $0 | $522 | 9.93% |
| DAVIDSON BENEFITS PLANNING LLC3 Filed as: DAVIDSON BENEFITS PLANNING, LLC. | 7632 SW DURHAM ROAD SUITE 115 TIGARD, OR 97224 | AMERITAS LIFE INSURANCE CORPORATION | $305 | $0 | $305 | 9.99% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP, INC. | 3 PARKWAY NORTH BOULEVARD SUITE 500 DEERFIELD, IL 60015 | AMERITAS LIFE INSURANCE CORPORATION | $0 | $53 | $53 | 1.74% |
| GCG FINANCIAL LLC3 Filed as: WILSON ALBERS, LLC. | 1201 PACIFIC AVENUE SUITE 2025 TACOMA, WA 98402 | AMERITAS LIFE INSURANCE CORPORATION | $0 | $27 | $27 | 0.88% |
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 | 129 | 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) | 129 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MODA HEALTH | 21 | $179K |
| Dental | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 34 | $54K |
| Vision | AMERITAS LIFE INSURANCE CORPORATION | 57 | $3K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 129 | $31K |
| Prescription drug(2 contracts, 2 carriers) | MODA HEALTH | 34 | $233K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 129 | $31K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 129 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.