| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DAVIDSON BENEFITS PLANNING LLC3 | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | REGENCE BLUECROSS BLUESHIELD OF OREGON | $20K | $1K | $21K | 2.59% |
| DAVIDSON BENEFITS PLANNING LLC3 Filed as: DAVIDSON BENEFITS PLANNING | 7632SW DURHAM RD 115 TIGARD, OR 97224 | VISION SERVICE PLAN | $787 | — | $787 | 7.12% |
| DAVIDSON BENEFITS PLANNING LLC3 | 7632 SW DURHAM RD, STE 115 TIGARD, OR 97224 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $686 | — | $686 | 13.09% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PACIFICSOURCE ADMINISTRATORS EIN 30-0140934 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $1K |
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 | 144 | 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) | 144 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | REGENCE BLUECROSS BLUESHIELD OF OREGON | 109 | $820K |
| Dental | DELTA DENTAL OF OREGON | 167 | $71K |
| Vision | VISION SERVICE PLAN | 128 | $11K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 144 | $5K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 144 | $5K |
| Prescription drug | REGENCE BLUECROSS BLUESHIELD OF OREGON | 109 | $820K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 167 | — |
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.