| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DAVIDSON BENEFITS PLANNING LLC3 | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $34K | $578 | $35K | 3.08% |
| LEMAR EISENHUT3 | 6400 NE HIGHWAY 99 STE G179 VANCOUVER, WA 98665 | AFLAC | $2K | $18 | $2K | 7.87% |
| MUELLER INSURANCE INC3 Filed as: MUELLER INS & FINANCIAL SVCS | PO BOX 3023 ELMA, WA 98541 | AFLAC | $146 | — | $146 | 0.58% |
| DAVIDSON BENEFITS PLANNING LLC3 | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | AFLAC | $126 | — | $126 | 0.50% |
| ERID OGREN3 | 4328 5TH AVE NW OLYMPIA, WA 98502 | AFLAC | $90 | — | $90 | 0.36% |
| ANDRE LAFLAMME3 | 9007 46TH CT NW GIG HARBOR, WA 98335 | AFLAC | $89 | — | $89 | 0.35% |
| PAUL B ROBEDEAU3 | 9523 BAY COURT CARMEL, CA 93923 | AFLAC | $85 | — | $85 | 0.34% |
| LARRY A MORRIS3 | 259 S SEQUOIA PKWY K093 CANBY, OR 97013 | AFLAC | $71 | — | $71 | 0.28% |
| MARK CHARLES MORGAN3 Filed as: MARK C MORGAN | 2590 WILLAMETTE DRIVE NE STE 102 LACEY, WA 98516 | AFLAC | $60 | — | $60 | 0.24% |
| CRUSADER INSURANCE INC3 | 20516 N 80TH LANE PEORIA, AZ 85382 | AFLAC | $44 | — | $44 | 0.18% |
| DANYELE D GROTHEN3 | 4617 NE ST JOHNS RD K134 VANCOUVER, WA 98661 | AFLAC | $41 | — | $41 | 0.16% |
| KRISTINE ELAINE MOORE3 | PO BOX 206 RANIER, OR 97048 | AFLAC | $40 | — | $40 | 0.16% |
| MARIA L SUA3 | 5225 JEAN RD APT 605 LAKE OSWEGO, OR 97035 | AFLAC | $37 | — | $37 | 0.15% |
| TIMOTHY MARTIN3 Filed as: TIMOTHY I MARTIN | 20516 N 80TH LANE PEORIA, AZ 85382 | AFLAC | $32 | — | $32 | 0.13% |
| JUSTIN ANDREW LOVINGIER3 | 16711 NE 13TH CIRCLE VANCOUVER, WA 98684 | AFLAC | $31 | — | $31 | 0.12% |
| RUZICKAS INC3 | 7416 93RD AVENUE CT SW LAKEWOOD, WA 98498 | AFLAC | $30 | — | $30 | 0.12% |
| PAUL SMILOWSKI3 | 8745 RAVINE DRIVE BEAVERTON, OR 97007 | AFLAC | $23 | — | $23 | 0.09% |
| DAVID J MCCLELLAN3 Filed as: DAVID JOHN HANNANT | 14830 NE 167TH ST WOODINVILLE, WA 98072 | AFLAC | $22 | — | $22 | 0.09% |
| VIRGINIA L KNOPSKI3 | 17001 MILL LANE LONG BEACH, WA 98631 | AFLAC | $18 | $4 | $22 | 0.09% |
| CRAIG A HANSEN3 | 200 17TH AVE E APT 404 SEATTLE, WA 98112 | AFLAC | $16 | — | $16 | 0.06% |
| DAVID J MCCLELLAN3 Filed as: DAVID W STEWART | 1001 COOPER POINT RD SW 140-201 OLYMPIA, WA 98502 | AFLAC | $16 | — | $16 | 0.06% |
| IOANNIS T GRATSINOPOULOS3 | 3565 SUMMERLINN DR WEST LINN, OR 97068 | AFLAC | $12 | $4 | $16 | 0.06% |
| JUSTIN ANDREW LOVINGIER3 | 17201 SE 24TH CRICLE VANCOUVER, WA 98683 | AFLAC | $15 | — | $15 | 0.06% |
| BRYAN JORAMO3 | 2606 STRASBURG DR FOREST GROVE, OR 97116 | AFLAC | $12 | — | $12 | 0.05% |
| MITCHELL HECTOR MORALES3 Filed as: MITCHELL PUMPIAN | 225 NE BIRCH STREET ISSAQUAH, WA 98027 | AFLAC | $9 | — | $9 | 0.04% |
| TIMOTHY ALLEN3 Filed as: TIMOTHY AARON ALLEN | 533 HICKORY ST BOAZ, AL 35956 | AFLAC | $6 | — | $6 | 0.02% |
| G SCOTT COOKE3 Filed as: SCOTT E NIELSEN | 1089 LAKE WASHINGTON BLVD N APT 306 RENTON, WA 98056 | AFLAC | $3 | — | $3 | 0.01% |
| SCOTT W BLACKSHEAR3 | 3453 CATHRYN DR COLUMBUS, GA 31906 | AFLAC | $1 | — | $1 | 0.00% |
| MICHAEL C WALKER3 Filed as: MICHAEL A STACHOWIAK | 321 N CLARK ST STE 625 CHICAGO, IL 60654 | AFLAC | $1 | — | $1 | 0.00% |
| JOSHUA PAUL GROUP INC3 Filed as: JOSHUA M HELDEROP | 10509 NE 120TH PLACE KIRKLAND, WA 98034 | AFLAC | $1 | — | $1 | 0.00% |
| MEGAN ELIZABETH CASTO3 Filed as: MEGAN J STEVENSON | 33305 1ST WAY S B203 FEDERAL WAY, WA 98003 | AFLAC | $1 | — | $1 | 0.00% |
| DAVIDSON BENEFITS PLANNING LLC3 | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $260 | $2K | 12.41% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AMERITAS LIFE INSURANCE CORP EIN 47-0098400 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $11K |
| ALLEGIANCE BENEFIT EIN 81-0400550 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 | 309 | 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) | 309 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 309 | $1.1M |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 96 | $19K |
| Short-term disability(2 contracts, 2 carriers) | AFLAC | 96 | $44K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 309 | $1.1M |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 96 | $19K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 309 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.