| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DAVIDSON BENEFITS PLANNING LLC3 | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | — | $5K | 2.50% |
| MATTECHECK & ASSOCIATES3 | 610 SW ALDER ST STE 310 PORTLAND, OR 97205 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | — | $5K | 2.50% |
| DAVIDSON BENEFITS PLANNING LLC3 | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 5.00% |
| MATTECHECK & ASSOCIATES3 | 610 SW ALDER ST STE 310 PORTLAND, OR 97205 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 5.00% |
| DAVIDSON BENEFITS PLANNING LLC3 | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 6.17% |
| MATTECHECK & ASSOCIATES3 | 610 SW ALDER ST STE 310 PORTLAND, OR 97205 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 6.17% |
| DAVIDSON BENEFITS PLANNING LLC3 | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 7.07% |
| MATTECHECK & ASSOCIATES3 | 610 SW ALDER ST STE 310 PORTLAND, OR 97205 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 7.07% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| REGENCE BLUECROSS BLUESHIELD OF ORE EIN 93-0238155 CONTRACT ADMINISTRATOR | Claims processing Service code 12 | — | $1.0M |
| CIGNA EIN 06-1059331 CONTRACT ADMINISTRATOR | Claims processing Service code 12 | — | $46K |
| INTEGRATED BEHAVORIAL HEALTH EIN 33-0851349 CONTRACT ADMINISTRATOR | Claims processing Service code 12 | — | $42K |
| EXPRESS SCRIPTS INC EIN 43-1420563 PRESCRIPTION ADMIN | Claims processing Service code 12 | — | $25K |
| VIVACITY EIN 26-4402130 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $7K |
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 | 2,136 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 26 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 98 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,260 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | REGENCE BLUECROSS BLUESHIELD OF OREGON | 4,315 | $1.8M |
| Vision | VISION SERVICE PLAN | 2,131 | $126K |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,655 | $281K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 144 | $65K |
| Long-term disability(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 462 | $122K |
| Prescription drug | REGENCE BLUECROSS BLUESHIELD OF OREGON | 4,315 | $1.8M |
| Other(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,655 | $44K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,315 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.