| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DAVIDSON BENEFITS PLANNING LLC3 Filed as: DAVIDSON BENEFITS PLANNING | 7632 SW DURHAM RD, SUITE 115 TIGARD, OR 97224 | UNITED HEALTHCARE INSURANCE COMPANY | $590 | $18K | $19K | 4.20% |
| DAVIDSON BENEFITS PLANNING LLC3 Filed as: DAVIDSON BENEFITS PLANNING | 7632 SW DURHAM RD, SUITE 115 TIGARD, OR 97224 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $1K | $0 | $1K | 1.24% |
| MARSH & MCLENNAN AGENCY LLC3 | LOCKBOX 740659 LOS ANGELES, CA 90074 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $927 | $0 | $927 | 0.87% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE OF ARIZONA | 2800 N CENTRAL AVE., STE. 1100 PHOENIX, AZ 85004 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $810 | $0 | $810 | 0.76% |
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 | 0 | 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) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 274 | $555K |
| Vision | UNITED HEALTHCARE INSURANCE COMPANY | 274 | $449K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 0 | $0 |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 0 | $0 |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 0 | $0 |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 0 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 274 | — |
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.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.