| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DAVIDSON BENEFITS PLANNING LLC3 | 7632 SW DURHAM ROAD STE 115 TIGARD, OR 97224 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $47 | $2K | 5.91% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPLOYEE BENEFIT MANAGEMENT SERVICE EIN 81-0391256 ADMINISTRATION | Contract Administrator Service code 13 | — | $100K |
| NAVITUS HEALTH SOLUTIONS EIN 04-3608530 PRESCRIPTION ADMIN | Other services Service code 49 | — | $14K |
| FIRST CHOICE HEALTH NETWORK EIN 91-1272766 PPO | Other services Service code 49 | — | $12K |
| EMPLOYEE BENEFIT MGMT SERVICES INC EIN 81-0391256 CASE MANAGEMENT | Other fees Service code 99 | — | $6K |
| EMPLOYEE BENEFIT MGMT SERVICES EIN 81-0391256 UTILIZATION REVIEW | Other fees Service code 99 | — | $6K |
| HEALTHCARE BLUEBOOK INC EIN 46-4399706 HEALTHCARE BLUEBOOK | Other services Service code 49 | — | $5K |
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 | 245 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 249 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | SUN LIFE OF CANADA | 532 | $504K |
| Life insurance | STANDARD INSURANCE COMPANY | 260 | $34K |
| Short-term disability | STANDARD INSURANCE COMPANY | 30 | $8K |
| Long-term disability | STANDARD INSURANCE COMPANY | 197 | $118K |
| Prescription drug | SUN LIFE OF CANADA | 532 | $473K |
| Stop-loss / reinsurancereinsurance | SUN LIFE OF CANADA | 532 | $473K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 400 | $42K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 532 | — |
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.