| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE, LLC DBA BENEFIT HEALTH | ADVISOR 9605 KINGSTON COURT, SUITE 140 ENGLEWOOD, CO 80112 | AMERICAN FIDELITY | $44K | — | $44K | 3.49% |
| INTERMOUNTAIN INSURANCE SERVICES3 | 136 S 1ST W REXBURG, ID 83440 | DELTA DENTAL OF IDAHO | $21K | — | $21K | 3.05% |
| CASTLE LAKE INSURANCE LLC3 | P.O. BOX 2751 IDAHO FALLS, ID 83403 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 0.71% |
| INTERMOUNTAIN INSURANCE SERVICES3 | 136 S 1ST W REXBURG, ID 83440 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 0.71% |
| CASTLE LAKE INSURANCE LLC3 | P.O. BOX 2751 IDAHO FALLS, ID 83403 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $13K | — | $13K | 7.48% |
| INTERMOUNTAIN INSURANCE SERVICES3 | 136 S 1ST W REXBURG, ID 83440 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $13K | — | $13K | 7.48% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK INK SOLUTIONS | 2240 E 25TH ST IDAHO FALLS, ID 83402 | WILLAMETTE DENTAL GROUP | $8K | — | $8K | 5.00% |
| EMPLOYEE FAMILY PROTECTION INC3 | PO BOX 1237 GLASTONBURY, CT 06033 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $37K | — | $37K | 26.79% |
| INTERMOUNTAIN INSURANCE SERVICES3 | 136 S 1ST W REXBURG, ID 83440 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 1.68% |
| CASTLE LAKE INSURANCE LLC3 | P.O. BOX 2751 IDAHO FALLS, ID 83403 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 1.54% |
| STEVEN RAY GRIFFIN3 | 2000 MORRIS AVE STE 1400 BIRMINGHAM, AL 35203 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 0.84% |
| MATTHEW B WALDRAM3 | PO BOX 2751 IDAHO FALLS, ID 83403 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $474 | — | $474 | 0.34% |
| CHARLES D. BLOCK3 Filed as: CHARLES D BLOCK | 648 VILLAGE PARK DR UNIT 208 WILMINGTON, NC 28405 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $324 | — | $324 | 0.23% |
| JAMES H. VAN EPPS3 Filed as: JAMES H VAN EPPS | 10930 CRABAPPLE RD STE 206 ROSWELL, GA 30075 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $322 | — | $322 | 0.23% |
| EMPLOYEE FAMILY PROTECTION INC3 | PO BOX 1237 GLASTONBURY, CT 06033 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $18K | — | $18K | 31.02% |
| INTERMOUNTAIN INSURANCE SERVICES3 | 136 S 1ST W REXBURG, ID 83440 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 1.88% |
| CASTLE LAKE INSURANCE LLC3 | PO BOX 2751 IDAHO FALLS, ID 83403 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 1.78% |
| STEVEN RAY GRIFFIN3 | 2000 MORRIS AVE STE 1400 BIRMINGHAM, AL 35203 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $351 | — | $351 | 0.61% |
| MATTHEW B WALDRAM3 | PO BOX 2751 IDAHO FALLS, ID 83403 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $115 | — | $115 | 0.20% |
| JAMES H. VAN EPPS3 Filed as: JAMES H VAN EPPS | 10930 CRABAPPLE RD STE 206 ROSWELL, GA 30075 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $65 | — | $65 | 0.11% |
| CHARLES D. BLOCK3 Filed as: CHARLES D BLOCK | 648 VILLAGE PARK DR, UNIT 208 WILMINGTON, NC 28405 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $65 | — | $65 | 0.11% |
| MATTHEW B WALDRAM3 | P.O. BOX 2751 IDAHO FALLS, ID 83403 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 14.00% |
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 | 1,145 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,145 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF IDAHO | 719 | $848K |
| Life insurance(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,145 | $651K |
| Short-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,145 | $430K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,145 | $422K |
| Stop-loss / reinsurancereinsurance | AMERICAN FIDELITY | 818 | $1.2M |
| Other(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,145 | $732K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,145 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.