| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DAVIDSON BENEFITS PLANNING LLC3 | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $1K | $9K | 12.57% |
| DAVIDSON BENEFITS PLANNING LLC3 | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $531 | $5K | 18.13% |
| DAVIDSON BENEFITS PLANNING LLC3 | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $326 | $3K | 11.02% |
| JOHN J DAVIDSON3 | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 9.75% |
| DAVIDSON BENEFITS PLANNING LLC3 | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 26.69% |
| DAVIDSON BENEFITS PLANNING LLC3 | 7632SW DURHAM ROAD STE 115 TIGARD, OR 97224 | HARTFORD LIFE AND ACCIDENT | $338 | — | $338 | 15.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 CLAIMS PROCESSOR | Claims processing; Other services Service code 12 | — | $204K |
| DAVIDSON BENEFITS PLANNING LLC EIN 93-1263635 BROKER | Insurance agents and brokers Service code 22 | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | $67K |
| MODA HEALTH-FORMERLY ODS EIN 93-0989307 CONTRACT ADMIN | Claims processing; Contract Administrator Service code 12 | PO BOX 40384 PORTLAND, OR 972400384 | $21K |
| EYEMED VISION CARE EIN 86-0773195 CONTRACT ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $12K |
| PACIFICSOURCE ADMIN INC/MANLEY SVCS EIN 30-0140934 CONTRACT ADMIN | Contract Administrator; Claims processing 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 | 338 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 7 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 347 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 457 | $383K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 300 | $96K |
| Short-term disability(3 contracts, 3 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 338 | $50K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 300 | $70K |
| Stop-loss / reinsurancereinsurance | UNITEDHEALTHCARE INSURANCE COMPANY | 457 | $360K |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 300 | $103K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 457 | — |
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.