| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GCG FINANCIAL LLC3 Filed as: DAVIDSON BENEFITS PLANNING/ALERA | 7632 SW DURHAM ROAD SUITE 115 TIGARD, OR 97224 | MODA HEALTH PLAN | $27K | $0 | $27K | 3.01% |
| MJ INSURANCE3 Filed as: MJI INC. | PO BOX 847 MCMINNVILLE, OR 97128 | MODA HEALTH PLAN | -$723 | $0 | -$723 | -0.08% |
| GCG FINANCIAL LLC3 Filed as: DAVIDSON BENEFITS PLANNING/ALERA | 7632 SW DURHAM ROAD SUITE 115 TIGARD, OR 97224 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $10K | $618 | $11K | 11.07% |
| MJ INSURANCE3 Filed as: MJI INC. | PO BOX 847 MCMINNVILLE, OR 97128 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | -$694 | $458 | -$236 | -0.24% |
| GCG FINANCIAL LLC3 Filed as: DAVIDSON BENEFITS PLANNING/ALERA | 7632 SW DURHAM ROAD SUITE 115 TIGARD, OR 97224 | WILLAMETTE DENTAL INSURANCE, INC. | $774 | $0 | $774 | 6.19% |
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 | 203 | 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) | 203 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MODA HEALTH PLAN | 95 | $888K |
| Dental(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 203 | $111K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 203 | $99K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 203 | $99K |
| Prescription drug | MODA HEALTH PLAN | 95 | $888K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 203 | $99K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 203 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.