| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DAVIDSON BENEFITS PLANNING LLC3 | 7632 SW DURHAM RD 115 TIGARD, OR 97224 | HEALTH NET | $32K | — | $32K | 2.30% |
| DAVIDSON BENEFITS PLANNING LLC3 | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | — | $6K | 2.99% |
| DAVIDSON BENEFITS PLANNING LLC3 Filed as: DAVIDSON BENEFITS PALNNING LLC | 7632 SW DURHAM RD 115 TIGARD, OR 97224 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $580 | $5K | 11.25% |
| DAVIDSON BENEFITS PLANNING LLC3 | 7632 SW DURHAM ROAD STE 115 TIGARD, OR 97224 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $205 | $3K | 17.47% |
| DAVIDSON BENEFITS PLANNING LLC3 | 7632 SW DURHAM ROAD STE 115 TIGARD, OR 97224 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $128 | $2K | 15.02% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF OREGON LLC | PO BOX 29018 PORTLAND, OR 97296 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $15 | — | $15 | 0.15% |
| PREFERRED BENEFITS LLC3 Filed as: PREFERRED BENEFITS INC | PO BOX 5597 TWIN FALLS, ID 83303 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.06% |
| DAVIDSON BENEFITS PLANNING LLC3 | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | EYEMED | $989 | — | $989 | 17.38% |
| DAVIDSON BENEFITS PLANNING LLC3 | 7632 SW DURHAM ROAD STE 115 TIGARD, OR 97224 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $444 | $44 | $488 | 16.50% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HR SIMPLIFIED EIN 41-1877873 CONTRACT ADMIN | Contract Administrator Service code 13 | — | $18K |
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 | 259 | 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) | 259 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTH NET | 255 | $1.4M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 393 | $188K |
| Vision(2 contracts, 2 carriers) | HEALTH NET | 255 | $1.4M |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 299 | $62K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 299 | $57K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 299 | $46K |
| Prescription drug | HEALTH NET | 255 | $1.4M |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 15 | $3K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 393 | — |
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."
No prospect flags tripped on this filing.