| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GCG FINANCIAL LLC3 Filed as: DAVIDSON BENEFITS AN ALERA AGENCY | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | SUN LIFE ASSURANCE COMPANY OF CANADA | $18K | — | $18K | 4.92% |
| UNITED BENEFIT ADVISORS NW LLC3 Filed as: UNITED BENEFIT ADVISORS NORTHWEST, | 3000 A STREET STE 400 ANCHORAGE, AK 99503 | SUN LIFE ASSURANCE COMPANY OF CANADA | -$648 | — | -$648 | -0.17% |
| GCG FINANCIAL LLC3 Filed as: DAVIDSON BENEFITS AN ALERA AGENCY | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $710 | — | $710 | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DAVIDSON BENEFITS PLANNING EIN 93-1263635 INSURANCE AGENT | Custodial (securities) Service code 19 | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | $27K |
| CYPRESS BENEFIT ADMINISTRATORS EIN 39-1997579 CONTRACT ADMIN | Claims processing Service code 12 | 5560 W GRANDE MARKET DR APPLETON, WI 54913 | $21K |
| INNOVATIVE CARE MANAGEMENT EIN 93-1087669 OTHER | Other fees Service code 99 | 12300 SE MALLARD WAY MILWAUKIE, OR 97222 | $9K |
| FIRST CHOICE HEALTH NETWORK EIN 91-1272766 OTHER | Other fees Service code 99 | 600 UNIVERSITY ST STE1400 SEATTLE, WA 98101 | $7K |
| CONSULT A DOCTOR EIN 31-1368946 OTHER | Other fees Service code 99 | — | $5K |
| EXPRESS SCRIPTS EIN 43-1420563 OTHER | Other fees Service code 99 | — | $2K |
| IDAHO PHYSICIANS NETWORK EIN 82-0462950 OTHER | Other fees Service code 99 | 408 E PARKCENTER BLVD BOISE, ID 83706 | $1K |
| HEALTHSMART EIN 75-2727437 OTHER | Other fees Service code 99 | — | $585 |
| PREMIERE HEALTHCARE EXCHANGE EIN 86-1040704 OTHER | Other fees Service code 99 | 2 CROSSROADS DR BEDMINSTER, NJ 07921 | $315 |
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 | 169 | 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) | 169 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 164 | $7K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 162 | $374K |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 164 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 164 | — |
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.