| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DAVIDSON BENEFITS PLANNING LLC3 | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | SUN LIFE ASSURANCE COMPANY OF CANADA | $13K | — | $13K | 5.00% |
| UNITED BENEFIT ADVISORS NW LLC3 Filed as: UNITED BENEFIT ADVISORS NORTHWEST L | 3000 A STREET STE 400 ANCHORAGE, AK 99503 | SUN LIFE ASSURANCE COMPANY OF CANADA | $6K | — | $6K | 2.50% |
| HEALTHCARE MANAGEMENT ADMINISTRATOR3 | 220 120TH AVE NE BELLEVUE, WA 98005 | SUN LIFE ASSURANCE COMPANY OF CANADA | $3K | — | $3K | 1.09% |
| UNITED BENEFIT ADVISORS LLC3 Filed as: UNITED BENEFIT ADVISORS INC | 10 WUNSHINE LANE RED LION, PA 17356 | SUN LIFE ASSURANCE COMPANY OF CANADA | $393 | — | $393 | 0.15% |
| DAVIDSON BENEFITS PLANNING LLC3 Filed as: DAVIDSON BENEFITS PLANNING, LLC | 7632 SW DURHAM RD. STE 115 TIGARD, OR 97224 | SUN LIFE ASSURANCE COMPANY OF CANADA | $3K | — | $3K | 2.94% |
| UNITED BENEFIT ADVISORS NW LLC3 | 7632 SW DURHAM RD STE 115 TIGARD, OR 97224 | SUN LIFE ASSURANCE COMPANY OF CANADA | $171 | — | $171 | 0.19% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTH MANAGEMENT ADMINISTRATORS EIN 91-1333840 CONTRACTOR ADMINISTRATOR | Contract Administrator Service code 13 | — | $61K |
| MODAHEALTH EIN 93-0438772 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $11K |
| DISCOVERY BENEFITS EIN 90-0058554 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $5K |
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 | 124 | 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) | 124 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | SUN LIFE ASSURANCE COMPANY OF CANADA | 119 | $258K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 125 | $92K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 125 | $92K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 125 | $92K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 119 | $258K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 125 | $92K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 125 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.