| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SCOTT BURKHARDT3 | 111 N 2ND STREET SUITE 10M COEUR D ALENE, ID 83814 | REGENCE BLUESHIELD OF IDAHO INC | $47K | $301 | $47K | 8.74% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | 701 B STREET 6TH FLOOR SAN DIEGO, CA 92101 | DELTA DENTAL OF IDAHO | $16K | $51K | $68K | 20.88% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | 701 B STREET 6TH FLOOR SAN DIEGO, CA 92101 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $20K | $997 | $21K | 13.50% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFIT ADMIN | PO BOX 1313 ORLANDO, FL 32802 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $17K | — | $17K | 12.39% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | 701 B STREET 6TH FLOOR SAN DIEGO, CA 92101 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $15K | $924 | $16K | 11.75% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | PO BOX 8299 PASADENA, CA 911098299 | VISION SERVICE PLAN | $6K | — | $6K | 9.91% |
| EMPLOYEE NAVIGATOR, LLC Filed as: EMPLOYEE NAVIGATOR | 7979 OLD GEORGETOWN RD STE 300 BETHESDA, MD 208142554 | VISION SERVICE PLAN | $86 | — | $86 | 0.14% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFIT ADMIN | PO BOX 1313 ORLANDO, FL 32802 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 10.90% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | 701 B STREET 6TH FLOOR SAN DIEGO, CA 92101 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 9.87% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFITS ADMIN | PO BOX 1313 ORLANDO, FL 32802 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 4.94% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | 10TH FLOOR 18100 VON KARMAN AVE IRVINE, CA 92612 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $852 | $852 | 1.45% |
| SCOTT BURKHARDT3 | 701 B STREET 6TH FLOOR SAN DIEGO, CA 92101 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $38 | — | $38 | 0.06% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFIT ADMIN | PO BOX 1313 ORLANDO, FL 32802 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 12.86% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | 701 B STREET 6TH FLOOR SAN DIEGO, CA 92101 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $321 | $5K | 10.93% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFIT ADMIN | PO BOX 1313 ORLANDO, FL 32802 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 8.57% |
| KOKO BROCKHOFF3 | 818 W RIVERSIDE AVE SUITE 800 SPOKANE, WA 99201 | NORTHWEST DENTAL BENEFITS | $42K | — | $42K | 100.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PREMIER MEDICAL RESOURCES INC EIN 20-2400714 EMPLOYEE MEDICAL SERVICES | Other services; Direct payment from the plan Service code 49 | 7399 N SHADELAND AVE UNIT 103 INDIANAPOLIS, IN 46250 | $527K |
| REGENCE BLUESHIELD OF IDAHO, INC EIN 82-0206874 CLAIMS PROCESSING SERVICE | Claims processing; Insurance brokerage commissions and fees; Direct payment from the plan; Contract Administrator; Float revenue; Other services; Non-monetary compensation Service code 12 | — | $444K |
| EDISON HEALTH NETWORKS LLC EIN 82-2140485 MEDICAL SERVICE CONTRACTO | Contract Administrator; Direct payment from the plan; Other services; Consulting (general) Service code 13 | PO BOX 1550 JENKS, OK 74037 | $65K |
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 | 653 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 653 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | REGENCE BLUESHIELD OF IDAHO INC | 1,054 | $538K |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF IDAHO | 469 | $366K |
| Vision | VISION SERVICE PLAN | 379 | $60K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,057 | $289K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 86 | $50K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,057 | $134K |
| Stop-loss / reinsurancereinsurance | REGENCE BLUESHIELD OF IDAHO INC | 1,054 | $538K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,057 | $192K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,057 | — |
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.