| 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 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $168 | $6K | 7.06% |
| GCG FINANCIAL LLC3 Filed as: DAVIDSON BENEFITS AN ALERA AGENCY | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $123 | $5K | 12.60% |
| JOHN J DAVIDSON3 | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 4.02% |
| GCG FINANCIAL LLC3 Filed as: DAVIDSON BENEFITS AN ALERA AGENCY | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $538 | $9 | $547 | 1.83% |
| GCG FINANCIAL LLC3 Filed as: DAVIDSON BENEFITS AN ALERA AGENCY | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $15 | $1K | 4.33% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 CLAIMS PROCESSOR | Other services; Claims processing Service code 12 | — | $195K |
| DAVIDSON BENEFITS AN ALERA AGENCY 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 | Contract Administrator; Claims processing Service code 12 | PO BOX 40384 PORTLAND, OR 972400384 | $25K |
| EYEMED VISION CARE EIN 86-0773195 CONTRACT ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $13K |
| PACIFICSOURCE ADMIN INC/MANLEY SVCS EIN 30-0140934 CONTRACT ADMIN | Claims processing; Contract Administrator Service code 12 | — | $4K |
| CASCADE CENTERS INC EIN 93-0774210 CONTRACT ADMINISTRATOR | 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 | 313 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 317 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 448 | $578K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 333 | $131K |
| Short-term disability(3 contracts, 3 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 313 | $60K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 333 | $89K |
| Stop-loss / reinsurancereinsurance | UNITEDHEALTHCARE INSURANCE COMPANY | 448 | $550K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 333 | $131K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 448 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.