| 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 | $6K | $808 | $6K | 10.01% |
| DAVIDSON BENEFITS PLANNING LLC3 | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $604 | $7K | 16.36% |
| DAVIDSON BENEFITS PLANNING LLC3 | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $114 | $2K | 6.66% |
| JOHN J DAVIDSON3 | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 3.18% |
| DAVIDSON BENEFITS PLANNING LLC3 | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $119 | $4K | 12.44% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 CLAIMS PROCESSOR | Claims processing Service code 12 | — | $194K |
| 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 Service code 12 | PO BOX 40384 PORTLAND, OR 972400384 | $27K |
| EYEMED VISION CARE EIN 86-0773195 CONTRACT ADMINISTRATOR | Claims processing Service code 12 | — | $14K |
| PACIFICSOURCE ADMIN INC/MANLEY SVCS EIN 30-0140934 CONTRACT ADMIN | 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 | 349 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 75 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 427 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 160 | $31K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 313 | $109K |
| Short-term disability(3 contracts, 3 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 349 | $64K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 313 | $65K |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 332 | $116K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 349 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.