| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DAVIDSON BENEFITS PLANNING LLC3 Filed as: DAVIDSON BENEFITS PLANNING | 7632 SW DURHAM ROAD, SUITE 115 TIGARD, OR 97224 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $15K | $2K | $16K | 5.81% |
| JAMES H. VAN EPPS3 | 10930 CRABAPPLE ROAD, SUITE 206 ROSWELL, GA 30075 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $775 | $8K | 2.83% |
| CHARLES D. BLOCK3 | 648 VILLAGE PARK DRIVE, SUITE 208 WILMINGTON, NC 28405 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $775 | $8K | 2.83% |
| THE PARTNERS GROUP3 | 11850 SW 67TH AVENUE, SUITE 100 PORTLAND, OR 97223 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $1K | $4K | 1.47% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS, INC. | 1 NORTH WHITE HORSE PIKE, SUITE 2 HAMMONTON, NJ 08037 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $821 | $0 | $821 | 0.29% |
| GRIFFIN, STEVEN, RAY3 | 2000 MORRIS AVENUE, SUITE 1400 BIRMINGHAM, AL 35203 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $13 | $0 | $13 | 0.00% |
| DAVIDSON BENEFITS PLANNING LLC3 Filed as: DAVIDSON BENEFITS PLANNING | 7632 SW DURHAM ROAD, SUITE 115 TIGARD, OR 97224 | VISION SERVICE PLAN | $1K | $0 | $1K | 4.80% |
| DAVIDSON BENEFITS PLANNING LLC3 Filed as: J. J. DAVIDSON | 7632 SW DURHAM ROAD, SUITE 115 TIGARD, OR 97224 | LEGALPLANS, USA | $0 | $353 | $353 | 14.98% |
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 | 390 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 391 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 48 | $193K |
| Dental | OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON | 419 | $153K |
| Vision | VISION SERVICE PLAN | 333 | $29K |
| Life insurance | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 1,103 | $191K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 1,103 | $191K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,422 | $279K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 48 | $193K |
| Other(4 contracts, 4 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,422 | $481K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,422 | — |
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."
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.