| 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 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $62K | $0 | $62K | 2.23% |
| MJ INSURANCE3 Filed as: MJI, INC. | PO BOX 847 MCMINNVILLE, OR 97128 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $21K | $1K | $23K | 0.82% |
| DAVIDSON BENEFITS PLANNING LLC3 Filed as: DAVIDSON BENEFITS PLANNING | 7632 SW DURHAM ROAD SUITE 115 TIGARD, OR 97224 | MODA HEALTH | $26K | $0 | $26K | 2.03% |
| MJ INSURANCE3 Filed as: MJI, INC. | PO BOX 847 MCMINNVILLE, OR 97128 | MODA HEALTH | $9K | $0 | $9K | 0.71% |
| MJ INSURANCE3 Filed as: MJI, INC. | PO BOX 847 MCMINNVILLE, OR 97128 | HARTFORD LIFE AND ACCIDENT | $4K | $346 | $4K | 3.36% |
| DAVIDSON BENEFITS PLANNING LLC3 Filed as: DAVIDSON BENEFITS PLANNING | 7632 SW DURHAM ROAD SUITE 115 TIGARD, OR 97224 | HARTFORD LIFE AND ACCIDENT | $4K | $0 | $4K | 3.10% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP, INC. | 3 PARKWAY NORTH BOULEVARD SUITE 500 DEERFIELD, IL 60015 | HARTFORD LIFE AND ACCIDENT | $0 | $697 | $697 | 0.53% |
| MJ INSURANCE3 Filed as: MJI, INC. | PO BOX 847 MCMINNVILLE, OR 97128 | WILLAMETTE DENTAL INSURANCE, INC. | $2K | $0 | $2K | 2.59% |
| DAVIDSON BENEFITS PLANNING LLC3 Filed as: DAVIDSON BENEFITS PLANNING | 7632 SW DURHAM ROAD SUITE 115 TIGARD, OR 97224 | WILLAMETTE DENTAL INSURANCE, INC. | $1K | $0 | $1K | 1.99% |
| MJ INSURANCE3 Filed as: MJI, INC. | PO BOX 847 MCMINNVILLE, OR 97128 | VISION SERVICE PLAN | $684 | $0 | $684 | 2.09% |
| DAVIDSON BENEFITS PLANNING LLC3 Filed as: DAVIDSON BENEFITS PLANNING | 7632 SW DURHAM ROAD SUITE 115 TIGARD, OR 97224 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | $0 | $3K | 15.69% |
| HAGAN HAMILTON INSURANCE3 | PO BOX 847 MCMINNVILLE, OR 97128 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | $0 | $1K | 4.96% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP, INC. | 965 GREENTREE ROAD SUITE 110 PITTSBURGH, PA 15220 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $286 | $286 | 1.31% |
| MJ INSURANCE4 Filed as: MJI, INC. | PO BOX 847 MCMINNVILLE, OR 97128 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $542 | $0 | $542 | 7.01% |
| JONATHAN BOOTH4 | 3844 NE JOEL STREET MCMINNVILLE, OR 97128 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $412 | $0 | $412 | 5.33% |
| DOUG A. SMITH4 | 2901 EAST 2ND STREET UNIT 60 NEWBERG, OR 97132 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $291 | $0 | $291 | 3.76% |
| DAVIDSON BENEFITS PLANNING LLC4 Filed as: DAVIDSON BENEFITS PLANNING | 7632 SW DURHAM ROAD SUITE 115 TIGARD, OR 97224 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $25 | $0 | $25 | 0.32% |
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 | 400 | 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) | 400 | 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 | 373 | $4.1M |
| Dental | WILLAMETTE DENTAL INSURANCE, INC. | 154 | $70K |
| Vision | VISION SERVICE PLAN | 272 | $33K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 390 | $131K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 390 | $131K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 373 | $4.1M |
| Other(4 contracts, 4 carriers) | MODA HEALTH | 390 | $1.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 390 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.