| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GCG FINANCIAL LLC3 Filed as: DAVIDSON BENEFITS AN ALERA AGENCY | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | SYMETRA LIFE INSURANCE COMPANY | — | $1K | $1K | 0.49% |
| GCG FINANCIAL LLC3 Filed as: DAVIDSON BENEFITS AN ALERA AGENCY | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 3.37% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 2.89% |
| GCG FINANCIAL LLC3 Filed as: DAVIDSON BENEFITS AN ALERA AGENCY | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $2K | $9K | 18.44% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 2.95% |
| GCG FINANCIAL LLC3 Filed as: DAVIDSON BENEFIT AN ALERA AGENCY | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | BENICOMP | $350 | — | $350 | 0.86% |
| GCG FINANCIAL LLC3 Filed as: DAVIDSON BENEFITS AN ALERA AGENCY | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | WILLAMETTE DENTAL INSURANCE INC | — | $4K | $4K | 12.00% |
| GCG FINANCIAL LLC3 Filed as: DAVIDSON BENEFITS AN ALERA AGENCY | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $960 | $960 | 2.93% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $823 | $823 | 2.51% |
| GCG FINANCIAL LLC3 Filed as: DAVIDSON BENEFITS AN ALERA AGENCY | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $250 | $3K | 16.50% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $214 | $214 | 1.28% |
| GCG FINANCIAL LLC3 Filed as: DAVIDSON BENEFITS AN ALERA AGENCY | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | — | $526 | $526 | 3.24% |
| GCG FINANCIAL LLC3 Filed as: DAVIDSON BENEFITS AN ALERA AGENCY | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 14.85% |
| BENEFIT ADVISORS NETWORK LLC3 Filed as: BENEFIT ADVISORS NETWORK | 23825 COMMERCE PARK BEACHWOOD, OR 44122 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $12 | — | $12 | 0.10% |
| GCG FINANCIAL LLC3 Filed as: DAVIDSON BENEFITS AN ALERA AGENCY | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $148 | $2K | 16.42% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $127 | $127 | 1.22% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SYMETRA FINANCIAL EIN 91-0742147 INSURER | Insurance services Service code 23 | — | $312K |
| HEALTHCARE MANAGEMENT ADMINISTRATOR EIN 91-1333840 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $140K |
| DAVIDSON BENEFITS AN ALERA AGENCY EIN 81-4473358 BROKER | Insurance agents and brokers Service code 22 | — | $40K |
| UNITED OF OMAHA LIFE INSURANCE COMP EIN 47-0322111 CONTRACT ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | — | $12K |
| QVI RISK SOLUTIONS INC EIN 57-1176571 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $10K |
| RXBENEFITS EIN 63-1157085 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $2K |
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 | 277 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 282 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | SYMETRA LIFE INSURANCE COMPANY | 270 | $416K |
| Dental(2 contracts, 2 carriers) | WILLAMETTE DENTAL INSURANCE INC | 230 | $50K |
| Vision | VISION SERVICE PLAN | 278 | $56K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 335 | $81K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 74 | $17K |
| Long-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 335 | $81K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 18 | $76K |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 270 | $289K |
| Other(3 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 335 | $92K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 335 | — |
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.