| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PETER MCDONALD3 Filed as: PETER D. MCDONALD | PO BOX 5815 BOISE, ID 83705 | PACIFICSOURCE HEALTH PLANS | $46K | $0 | $46K | 3.45% |
| PETER MCDONALD3 | 157 RIVER VISTA PLACE TWIN FALLS, ID 83301 | UNITED HERITAGE LIFE INSURANCE COMPANY | $11K | $0 | $11K | 12.65% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTL. MOUNTAIN STATES, LLC | 3545 GABEL ROAD BILLINGS, MT 59102 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $2K | $3K | 18.39% |
| SUSAN MAHONEY4 | 1116 SOUTH VISTA AVENUE, PMB 374 BOISE, ID 83705 | LEGALSHIELD | $867 | $0 | $867 | 13.70% |
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 | 191 | 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) | 191 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PACIFICSOURCE HEALTH PLANS | 234 | $1.3M |
| Dental | DELTA DENTAL OF IDAHO | 151 | $118K |
| Vision | UNITED HERITAGE LIFE INSURANCE COMPANY | 137 | $90K |
| Life insurance | UNITED HERITAGE LIFE INSURANCE COMPANY | 137 | $90K |
| Short-term disability | UNITED HERITAGE LIFE INSURANCE COMPANY | 137 | $90K |
| Long-term disability | UNITED HERITAGE LIFE INSURANCE COMPANY | 137 | $90K |
| Prescription drug | PACIFICSOURCE HEALTH PLANS | 234 | $1.3M |
| Other(4 contracts, 4 carriers) | UNITED HERITAGE LIFE INSURANCE COMPANY | 191 | $123K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 234 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.