| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | PO BOX 3009 SUITE 670 ARLINGTON HEIGHTS, IL 60006 | CONTINENTAL AMERICAN INSURANCE COMPANY | $25K | $0 | $25K | 30.20% |
| BUFORD LEROY ELLIOTT3 | 560 FILER AVE SUITE A TWIN FALLS, ID 83303 | CONTINENTAL AMERICAN INSURANCE COMPANY | $14K | $0 | $14K | 16.82% |
| RICHARD R KIMBROUGH3 Filed as: RICHARD KIMBROUGH | 6380 N PARK MEADOW WAY APT 203 BOISE, IA 83713 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3K | $0 | $3K | 3.57% |
| TYGER RICHMAN3 | 430 FAIRMONT AVE POCATELLO, ID 83201 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3K | $0 | $3K | 3.57% |
| SIMON E TAUTALA3 | 1406 N MAIN ST SUITE 116 MERIDIAN, IA 83642 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | $0 | $2K | 1.86% |
| DAVID WADE3 | 6967 S RIVERGATE DR SUITE 200 MIDVALE, UT 84047 | UNITED HERITAGE LIFE INSURANCE COMPANY | $4K | $0 | $4K | 11.17% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | PO BOX 3009 SUITE 670 ARLINGTON HEIGHTS, IL 60006 | UNITED HEALTHCARE INSURANCE COMPANY | — | — | $0 | 0.00% |
| JP GRIFFETH ENTERPRISES INC3 Filed as: JP GRIFFETH ENTERPRISES, INC. | 12416 WEST BRADDOCK DRIVE BOISE, ID 83709 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $62 | $0 | $62 | 1.03% |
| WILLIAM KEZELE3 | 4370 STONEBROOK LANE IDAHO FALLS, ID 83404 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $32 | $0 | $32 | 0.53% |
| VIRGINIA KEZELE3 Filed as: VIRGINIA AYLES KEZELE | 15377 W VERDE LN GOODYEAR, AZ 85395 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $28 | $0 | $28 | 0.46% |
| FEATHER GROUP LLC3 Filed as: FEATHER GROUP, LLC. | 5369 N ISLA AVENUE MERIDIAN, ID 83646 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $25 | $0 | $25 | 0.41% |
| ZINA OSTER3 | 3153 FOREST DRIVE CHEYENNE, WY 82001 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | $0 | $10 | 0.17% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX EIN 33-0441200 PHARMACY BENEFIT MGMT | Direct payment from the plan; Claims processing; Float revenue; Other fees Service code 12 | — | $184K |
| GALLAGHER BENEFIT SERVICES INC ADMINISTRATOR | Contract Administrator Service code 13 | PO BOX 3009 SUITE 670 ARLINGTON HEIGHTS, IL 60006 | $25K |
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $17K |
| DAVID WADE BROKER | Other commissions Service code 55 | 6967 S RIVERGATE DR SUITE 200 MIDVALE, IL 84047 | $4K |
| RICHARD R KIMBROUGH ADMINISTRATOR | Contract Administrator Service code 13 | 6380 N PARK MEADOW WAY APT 203 BOISE, ID 83713 | $3K |
| TYGER RICHMAN ADMINISTRATOR | Contract Administrator Service code 13 | 430 FAIRMONT AVE POCATELLO, ID 83201 | $3K |
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 | 136 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 65 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 201 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | UNITED HERITAGE LIFE INSURANCE COMPANY | 125 | $44K |
| Short-term disability(2 contracts, 2 carriers) | CONTINENTAL AMERICAN INSURANCE COMPANY | 140 | $89K |
| Other(3 contracts, 3 carriers) | CONTINENTAL AMERICAN INSURANCE COMPANY | 185 | $99K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 185 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.