| 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 | $18K | — | $18K | 4.58% |
| HEALTHCARE MANAGEMENT ADMINISTRATOR3 | 220 120TH AVE NE BELLEVUE, WA 98005 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $8K | $8K | 2.09% |
| 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 | $822 | — | $822 | 0.21% |
| 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 | — | $4K | $4K | 4.09% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SUN LIFE ASSURANCE COMPANY OF CANAD EIN 38-1082080 CONTRACT ADMINISTRATOR | Insurance services Service code 23 | — | $353K |
| HEALTH MANAGEMENT ADMINISTRATORS EIN 91-1333840 CONTRACTOR ADMINISTRATOR | Contract Administrator Service code 13 | — | $64K |
| MODA HEALTH EIN 93-0438772 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $15K |
| 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 | 152 | 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) | 152 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | SUN LIFE ASSURANCE COMPANY OF CANADA | 160 | $385K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 166 | $104K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 166 | $104K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 166 | $104K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 160 | $385K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 166 | $104K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 166 | — |
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.