| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BLACK INK BENEFITS3 Filed as: BLACK INK INSURANCE INC DBA | INTERMOUNTAIN INSURANCE SERVICE 136 S 1ST W REXBURG, ID 83440 | DELTA DENTAL OF IDAHO | $2K | — | $2K | 2.10% |
| CASTLE LAKE INSURANCE LLC3 Filed as: CASTLE LAKE INSURANCE, LLC | 1601 ANTLER DR IDAHO FALLS, ID 83404 | DELTA DENTAL OF IDAHO | $723 | — | $723 | 0.90% |
| MATTHEW B WALDRAM3 Filed as: MATTHEW WALDRAM | 1601 ANTLER DR IDAHO FALLS, ID 834041226 | UNITED HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| CASTLE LAKE INSURANCE LLC3 Filed as: CASTLE LAKE INSURANCE | 1601 ANTLER DR IDAHO FALLS, ID 83404 | USABLE LIFE | $810 | — | $810 | 10.03% |
| MATTHEW B WALDRAM3 | 1601 ANTLER DR IDAHO FALLS, ID 83404 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $171 | — | $171 | 6.37% |
| DENISE A MAXWELL3 | 3501 W TORANA DR MERIDIAN, ID 83646 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $26 | $0 | $26 | 0.97% |
| LYNSAY GROSS3 | 472 W CAGNEY ST MERIDIAN, ID 83646 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.11% |
| LOIS FLEENER3 | 2165 NE CURRIN CREEK DR ESTACADA, OR 97023 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $0 | $2 | 0.07% |
| MATTHEW B WALDRAM3 | 1601 ANTLER DR IDAHO FALLS, ID 83404 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $326 | — | $326 | 13.20% |
| RONNY ANN WARNER3 | 470 E WHITBECK ST KUNA, ID 83634 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $27 | $15 | $42 | 1.70% |
| DENISE A MAXWELL3 | 3501 W TORANA DR MERIDIAN, ID 83646 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $34 | $2 | $36 | 1.46% |
| LOIS FLEENER3 | 2165 NE CURRIN CREEK DR ESTACADA, OR 97023 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | $0 | $15 | 0.61% |
| LYNSAY GROSS3 | 472 W CAGNEY ST MERIDIAN, ID 83646 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.12% |
| MATTHEW B WALDRAM3 | 1601 ANTLER DR IDAHO FALLS, ID 83404 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $58 | — | $58 | 4.50% |
| DENISE A MAXWELL3 | 3501 W TORANA DR MERIDIAN, ID 83646 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | — | $10 | 0.78% |
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 | 181 | 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) | 181 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 5 | $6K |
| Dental | DELTA DENTAL OF IDAHO | 161 | $80K |
| Vision | UNITED HERITAGE LIFE INSURANCE COMPANY | 143 | $15K |
| Life insurance | USABLE LIFE | 205 | $8K |
| Other(4 contracts, 2 carriers) | USABLE LIFE | 205 | $15K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 205 | — |
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."
No prospect flags tripped on this filing.