| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DAVIDSON BENEFITS PLANNING LLC3 | 7632 SW DURHAM RD 115 TIGARD, OR 97224 | MODA HEALTH PLAN INC | $77K | — | $77K | 5.72% |
| DAVIDSON BENEFITS PLANNING LLC3 | 7632 SW DURHAM RD, STE 115 TIGARD, OR 97224 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $7K | $81 | $7K | 3.04% |
| DAVIDSON BENEFITS PLANNING LLC3 | 7632 SW DURHAM RD 115 TIGARD, OR 97224 | DELTA DENTAL OF OREGON | $5K | — | $5K | 5.72% |
| DAVIDSON BENEFITS PLANNING LLC3 Filed as: DAVIDSON BENEFITS PLANNING, LLC | 7632 SW DURHAM RD, STE 115 TIGARD, OR 97224 | STANDARD INSURANCE COMPANY | $5K | — | $5K | 8.11% |
| DAVIDSON BENEFITS PLANNING LLC3 Filed as: DAVIDSON BENEFITS PLANNING, LLC | 7632 SW DURHAM RD, STE 115 TIGARD, OR 97224 | STANDARD INSURANCE COMPANY | $4K | — | $4K | 6.30% |
| DAVIDSON BENEFITS PLANNING LLC3 | 7632 SW DURHAM RD, STE 115 TIGARD, OR 97224 | STANDARD INSURANCE COMPANY | $3K | — | $3K | 5.40% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENEFIT HELP SOLUTIONS EIN 93-1135521 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $4K |
| CASCADE CENTERS EIN 93-0774210 CONTRACT ADMINISTRATORS | Contract Administrator Service code 13 | — | $3K |
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 | 113 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 114 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | MODA HEALTH PLAN INC | 177 | $1.6M |
| Dental | DELTA DENTAL OF OREGON | 177 | $92K |
| Vision | MODA HEALTH PLAN INC | 177 | $1.3M |
| Life insurance | STANDARD INSURANCE COMPANY | 113 | $50K |
| Short-term disability | STANDARD INSURANCE COMPANY | 112 | $57K |
| Long-term disability | STANDARD INSURANCE COMPANY | 113 | $63K |
| Prescription drug | MODA HEALTH PLAN INC | 177 | $1.3M |
| Stop-loss / reinsurancereinsurance | MODA HEALTH PLAN INC | 177 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 177 | — |
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.