| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DAVIDSON BENEFITS PLANNING LLC3 | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | LINCOLN NATIONAL LIFE INSURANCE CO | $4K | — | $4K | 10.41% |
| DAVIDSON BENEFITS PLANNING LLC3 | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | LINCOLN NATIONAL LIFE INSURANCE CO | $2K | — | $2K | 9.38% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 CLAIMS PROCESSOR | Claims processing; Other services Service code 12 | — | $173K |
| DAVIDSON BENEFITS PLANNING LLC EIN 93-1263635 BROKER | Insurance agents and brokers Service code 22 | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | $66K |
| MODA HEALTH-FORMERLY ODS EIN 93-0989307 CONTRACT ADMIN | Contract Administrator; Claims processing Service code 12 | PO BOX 40384 PORTLAND, OR 972400384 | $21K |
| EYEMED VISION CARE EIN 86-0773195 CONTRACT ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | — | $4K |
| PACIFICSOURCE ADMIN INC/MANLEY SVCS EIN 30-0140934 CONTRACT ADMIN | Claims processing; Contract Administrator Service code 12 | — | $4K |
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 | 319 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 6 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 326 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | LINCOLN NATIONAL LIFE INSURANCE CO | 292 | $23K |
| Short-term disability | LINCOLN NATIONAL LIFE INSURANCE CO | 292 | $23K |
| Long-term disability | LINCOLN NATIONAL LIFE INSURANCE CO | 291 | $37K |
| Stop-loss / reinsurancereinsurance | UNITEDHEALTHCARE INSURANCE COMPANY | 254 | $311K |
| Other | RELIANT BEHAVIORAL HEALTH LLC | 292 | $8K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 292 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.