| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DAVIDSON BENEFITS PLANNING LLC3 | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | VISION SERVICE PLAN | $926 | — | $926 | 6.19% |
| AKT BENEFIT ADVISORS LP3 | 680 HAWTHORNE AVE SE STE 140 SALEM, OR 97301 | LIFEMAP ASSURANCE COMPANY | $131 | — | $131 | 1.64% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES INC EIN 41-1289245 CLAIMS PROCESSOR | Claims processing Service code 12 | — | $66K |
| BHS SERVICES EIN 93-1135521 CONTRACT ADMINISTRATOR | Claims processing Service code 12 | — | $15K |
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 | 140 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 140 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 397 | $577K |
| Dental | WILLAMETTE DENTAL INSURANCE INC | 276 | $157K |
| Vision | VISION SERVICE PLAN | 118 | $15K |
| Life insurance | LIFEMAP ASSURANCE COMPANY | 98 | $8K |
| Short-term disability | LIFEMAP ASSURANCE COMPANY | 98 | $8K |
| Long-term disability | LIFEMAP ASSURANCE COMPANY | 98 | $8K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 397 | $542K |
| Other | RELIANT BEHAVORIAL HEALTH | 140 | $3K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 397 | — |
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.