| 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 | OREGON DENTAL SERVICE DBA DELTA DENTAL PLAN OF OREGON | $2K | — | $2K | 3.14% |
| GCG FINANCIAL LLC3 Filed as: DAVIDSON BENEFITS AN ALERA AGENCY | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | VISION SERVICE PLAN | $959 | — | $959 | 5.53% |
| MARK A MCRAE3 Filed as: MARK MCRAE | 375 NE SOUTH NEBBERGALL LOOP ALBANY, OR 97321 | AFLAC | $1K | $193 | $2K | 13.31% |
| ELIZABETH HUDDLESTON3 | PO BOX 208 CORVALLIS, OR 97339 | AFLAC | $580 | — | $580 | 4.65% |
| VINCENT BRIAN VOLLMAR3 Filed as: VINCENT VOLLMAR | 777 COMMERCIAL ST SE STE 20 SALEM, OR 97301 | AFLAC | $271 | $39 | $310 | 2.49% |
| TIFFANY M HEBERT3 Filed as: TIFFANY HEBERT | 567 SE CYPRESS AVE DALLAS, OR 97338 | AFLAC | $204 | $39 | $243 | 1.95% |
| BARKER-UERLINGS INSURANCE3 Filed as: BARKER-UERLINGS INS INC | PO BOX 1378 CORVALLIS, OR 97339 | AFLAC | $117 | — | $117 | 0.94% |
| JULIA MCBURNEY3 | 3825 PLEASANT RIDGE RD THE DALLES, OR 97058 | AFLAC | $61 | — | $61 | 0.49% |
| WILLIAM R MEDITZ3 Filed as: WILLIAM MEDITZ | 25884 SW CANYON CREEK RD APT J202 WILSONVILLE, OR 97070 | AFLAC | $46 | — | $46 | 0.37% |
| CINDY UNRUH3 | 2415 FISHER RD NE SALEM, OR 97305 | AFLAC | $38 | — | $38 | 0.30% |
| ALICIA J MATSON3 Filed as: ALICIA MATSON | 6027 ROLLETTI DR SE SALEM, OR 97306 | AFLAC | $34 | — | $34 | 0.27% |
| NATHAN HANSEN3 | 745 E DUSTY CREEK AVE SANDY, UT 84094 | AFLAC | $23 | — | $23 | 0.18% |
| SHEILA MEARS3 | 3420 GARDENIA AVE LONG BEACH, CA 90807 | AFLAC | $15 | — | $15 | 0.12% |
| JEFFORY MERTEN3 | 906 NW LEWISBURG AVE CORVALLIS, OR 97330 | AFLAC | $13 | — | $13 | 0.10% |
| DEANNA LATIMORE3 | 5455 1/2 ALVERN CIR LOS ANGELES, CA 90045 | AFLAC | $11 | — | $11 | 0.09% |
| GUY R SOUTER3 Filed as: GUY SOUTER | PO BOX 1283 LA PINE, OR 97739 | AFLAC | $10 | — | $10 | 0.08% |
| 3P INS SVCS CORP3 | 5455 1/2 ALVERN CIR LOS ANGELES, CA 90045 | AFLAC | $10 | — | $10 | 0.08% |
| PAUL HANNANT3 | 6052 SAWGRASS ST SE SALEM, OR 97306 | AFLAC | $8 | — | $8 | 0.06% |
| STEVEN R. JOHNSON3 Filed as: STEVEN JOHNSON | 6167 BRISTOL PKWY STE 106 CULVER CITY, CA 90230 | AFLAC | $7 | — | $7 | 0.06% |
| SCOTT NIELSEN3 | 718B W FOURTH PLAIN BLVD VANCOUVER, WA 98660 | AFLAC | $5 | — | $5 | 0.04% |
| RAYMON P KEECH III3 Filed as: RAYMON KEECH III | 8207 CAMPAIGN CIR RICHMOND, TX 77406 | AFLAC | $4 | — | $4 | 0.03% |
| SHANE EDMUND ATTEBERY3 Filed as: SHANE ATTEBERY | 391 RANDY DR GRANTS PASS, OR 97527 | AFLAC | $4 | — | $4 | 0.03% |
| STEVEN R. JOHNSON3 Filed as: STEVEN JOHNSON | 2239 W 190TH ST TORRANCE, CA 90504 | AFLAC | $3 | — | $3 | 0.02% |
| IOANNIS T GRATSINOPOULOS3 Filed as: IOANNIS GRATSINOPOULOS | 1893 E DAULBY ST MERIDIAN, ID 83642 | AFLAC | $3 | — | $3 | 0.02% |
| ERIC DANIEL WEILAND3 Filed as: ERIC WEILAND | 14511 SW CORNERSTONE LN SHERWOOD, OR 97140 | AFLAC | $1 | — | $1 | 0.01% |
| GINA SIENIA3 Filed as: GINA SIENIS | PO BOX 446 ECHO, OR 97826 | AFLAC | $1 | — | $1 | 0.01% |
| KIMBERLY A PARKS Filed as: KIMBERLY PARKS | 19818 N 147TH DR SUN CITY WEST, AZ 85375 | AFLAC | $1 | — | $1 | 0.01% |
| GCG FINANCIAL LLC3 Filed as: DAVIDSON BENEFITS AN ALERA AGENCY | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | LIFEMAP ASSURANCE COMPANY | $218 | — | $218 | 2.31% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES INC EIN 41-1289245 CLAIMS PROCESSOR | Contract Administrator; Claims processing Service code 12 | — | $21K |
| BHS SERVICES EIN 93-1135521 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $9K |
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 | 285 | 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) | 285 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 293 | $566K |
| Dental(2 contracts, 2 carriers) | WILLAMETTE DENTAL INSURANCE INC | 181 | $154K |
| Vision | VISION SERVICE PLAN | 141 | $17K |
| Life insurance | LIFEMAP ASSURANCE COMPANY | 133 | $9K |
| Short-term disability(2 contracts, 2 carriers) | AFLAC | 133 | $22K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 293 | $566K |
| Other | LIFEMAP ASSURANCE COMPANY | 133 | $9K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 293 | — |
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.