| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DAVIDSON BENEFITS PLANNING LLC3 | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | SUN LIFE ASSURANCE COMPANY OF CANADA | $68K | — | $68K | 5.39% |
| UNITED BENEFIT ADVISORS NW LLC3 Filed as: UNITED BENEFIT ADVISORS NORTHWEST L | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | SUN LIFE ASSURANCE COMPANY OF CANADA | $34K | — | $34K | 2.69% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| REGENCE BLUECROSS BLUESHIELD OF OR EIN 93-0238155 CLAIMS PROCESSING | Float revenue; Claims processing; Direct payment from the plan Service code 12 | — | $1.2M |
| DAVIDSON BENEFITS PLANNING LLC EIN 93-1263635 BROKER | Insurance agents and brokers Service code 22 | — | $50K |
| NAVIA BENEFITS EIN 77-0252693 CLAIMS PROCESSING | Claims processing Service code 12 | — | $35K |
| PAYFLEX INC EIN 91-1774434 CLAIMS PROCESSING | Claims processing Service code 12 | — | $10K |
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 | 2,525 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 23 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 90 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,638 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ZOOM HEALTH PLAN, INC | 176 | $452K |
| Vision | VISION SERVICE PLAN | 1,859 | $197K |
| Life insurance(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 2,732 | $228K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 3,177 | $328K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 634 | $72K |
| Prescription drug | ZOOM HEALTH PLAN, INC | 176 | $452K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 6,896 | $1.3M |
| Other(3 contracts, 2 carriers) | CASCADE CENTERS | 3,138 | $200K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 6,896 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.