| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE AGENCY, INC. | 738 N. FIRST ST., SUITE 202 SAN JOSE, CA 95112 | SUN LIFE ASSURANCE COMPANY OF CANADA | $43K | — | $43K | 3.79% |
| DAVIDSON BENEFITS PLANNING LLC3 Filed as: DAVIDSON BENEFITS PLANNING, LLC | 7632 SW DURHAM RD 115 TIGARD, OR 97224 | SUN LIFE ASSURANCE COMPANY OF CANADA | $40K | — | $40K | 3.46% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS. & FINANCIAL SEVC | PO BOX 29678, DEPT#2027 PHOENIX, AZ 85038 | SUN LIFE ASSURANCE COMPANY OF CANADA | $28K | — | $28K | 2.44% |
| HEALTHCARE MANAGEMENT ADMINISTRATOR3 Filed as: HEALTHCARE MANAGEMENT ADMIN., INC. | 220 120 AVE., SUITE 200 BELLEVUE, WA 98005 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $23K | $23K | 1.96% |
| UNITED BENEFIT ADVISOR NORTHWEST3 | 3000 A ST., SUITE 400 ANCHORAGE, AK 99503 | SUN LIFE ASSURANCE COMPANY OF CANADA | $9K | — | $9K | 0.79% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE AGENCY, INC. | 738 N. FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | OREGON DENTAL SERVICE | $14K | — | $14K | 2.05% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE AGENCY, INC. | 738 NORTH FIRST ST., SUITE 202 SAN JOSE, CA 95112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $1K | $5K | 5.37% |
| DAVIDSON BENEFITS PLANNING LLC3 | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $204 | $3K | 3.68% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE AGENCY, INC. | 738 NORTH FIRST ST., SUITE 202 SAN JOSE, CA 95112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $1K | $9K | 10.06% |
| DAVIDSON BENEFITS PLANNING LLC3 Filed as: DAVIDSON BENEFITS PLANNING, LLC | 7632 SW DURHAM ROAD, SUITE 115 TIGARD, OR 97224 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $249 | $5K | 6.20% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE AGENCY, INC. | 738 NORTH FIRST ST., SUITE 202 SAN JOSE, CA 95112 | VISION SERVICE PLAN | $1K | — | $1K | 1.53% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE AGENCY, INC. | 738 NORTH FIRST ST., SUITE 202 SAN JOSE, CA 95112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $303 | $2K | 6.56% |
| DAVIDSON BENEFITS PLANNING LLC3 | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $881 | $77 | $958 | 3.72% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE AGENCY, INC. | 738 NORTH FIRST ST., SUITE 202 SAN JOSE, CA 95112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $250 | $1K | 7.41% |
| DAVIDSON BENEFITS PLANNING LLC3 | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $616 | $50 | $666 | 3.46% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE AGENCY, INC. | 738 N. FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | VISION SERVICE PLAN | $249 | — | $249 | 1.44% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE AGENCY, INC. | 738 NORTH FIRST ST., SUITE 202 SAN JOSE, CA 95112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $418 | $56 | $474 | 9.67% |
| DAVIDSON BENEFITS PLANNING LLC3 | 7632 SW DURHAM RD., 115 TIGARD, OR 97224 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $318 | $16 | $334 | 6.81% |
| BENEFIT COMMUNICATIONS INC3 Filed as: BENEFIT COMMUNICATIONS, INC. | 2977 SIDCO DRIVE NASHVILLE, TN 37204 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $198 | — | $198 | 7.89% |
| JOHN JOSEPH DAVIDSON3 | 8050 SW WARM SPRINGS STREET TIGARD, OR 97062 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $21 | — | $21 | 0.84% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTHCARE MANAGEMENT ADMINISTRATOR EIN 91-1333840 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $255K |
| FILICE INSURANCE AGENCY, INC. EIN 77-0261203 BROKER | Insurance agents and brokers Service code 22 | — | $18K |
| DAVIDSON BENEFITS PLANNING LLC EIN 93-1263635 BROKER | Insurance agents and brokers Service code 22 | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | $8K |
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 | 644 | 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) | 644 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | OREGON DENTAL SERVICE | 644 | $681K |
| Vision(2 contracts) | VISION SERVICE PLAN | 444 | $96K |
| Life insurance(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 529 | $50K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 94 | $86K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 94 | $86K |
| Other(5 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 529 | $137K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 644 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.