| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CONOVER INSURANCE SERVICES LLC3 | 125 M 50TH AVENUE YAKIMA, WA 989082862 | LIFEWISE ASURANCE COMPANY | — | $789 | $789 | 0.20% |
| GCG FINANCIAL LLC3 Filed as: DAVIDSON BENEFITS AN ALERA AGENCY | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $19K | — | $19K | 6.08% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DAVIDSON BENEFITS AN ALERA AGENCY EIN 93-1263635 BROKER | Insurance agents and brokers Service code 22 | — | $52K |
| PREMERA BLUE CROSS EIN 91-0499247 CONTRACT ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $31K |
| HR SIMPLIFIED EIN 41-1877873 CONTRACT ADMINISTRATOR | 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 | 287 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 290 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | LIFEWISE ASURANCE COMPANY | 242 | $403K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 258 | $305K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 258 | $305K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 258 | $305K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 258 | $305K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 258 | $305K |
| Stop-loss / reinsurancereinsurance | LIFEWISE ASURANCE COMPANY | 242 | $403K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 258 | $305K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 258 | — |
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.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.