| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BRANDON PENKO3 Filed as: BRANDON SIMON | PO BOX 3725 COEUR D ALENE, ID 83816 | UNITED HERITAGE LIFE INSURANCE COMPANY | $19K | $0 | $19K | 4.54% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | UNKNOWN CORUR D ALENE, ID 83816 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $28K | $11K | $39K | 32.50% |
| WORKSITE BENEFITS GROUP INC3 Filed as: WORKSITE BENEFITS GROUP, INC. | 112 NW, 114TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $2K | $3K | 2.92% |
| BENEFITS BY DESIGN INC3 Filed as: BENEFITS BY DESIGN, INC. | 2101 NE, 279TH STREET RIDGEFIELD, WA 98642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $954 | $3K | 2.65% |
| GABRIEL ANGEL CANALS3 | 1549 NW CIVIC DRIVE, APARTMENT 204 GRESHAM, OR 97030 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $575 | $476 | $1K | 0.88% |
| JORDAN TEDESCO3 | 1412 6TH AVENUE NORTH SEATTLE, WA 98109 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $966 | $13 | $979 | 0.82% |
| MELLONEASE KIRKSEY3 | 1664 CEDAR SPRINGS COURT CLARKSVILLE, TN 37042 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $494 | $62 | $556 | 0.47% |
| ROXANA BUSCHMAN3 Filed as: ROXANA BUSCHMAN & OTHER AGENTS | 400 NE, 149TH STREET VANCOUVER, WA 98685 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $401 | $65 | $466 | 0.39% |
No Schedule C service providers reported on this filing.
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 | 386 | 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) | 386 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | UNITED HERITAGE LIFE INSURANCE COMPANY | 406 | $413K |
| Short-term disability | UNITED HERITAGE LIFE INSURANCE COMPANY | 406 | $413K |
| Long-term disability | UNITED HERITAGE LIFE INSURANCE COMPANY | 406 | $413K |
| Other(2 contracts, 2 carriers) | UNITED HERITAGE LIFE INSURANCE COMPANY | 406 | $533K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 406 | — |
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.