| 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 | GERBER LIFE | — | — | $0 | 0.00% |
| INTERMOUNTAIN INSURANCE SERVICES3 | 136 S 1ST W REXBURG, ID 83440 | DELTA DENTAL OF IDAHO | $27K | — | $27K | 3.00% |
| CASTLE LAKE INSURANCE LLC3 | P.O. BOX 2751 IDAHO FALLS, ID 83403 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $12K | — | $12K | 2.24% |
| INTERMOUNTAIN INSURANCE SERVICES3 | 136 S 1ST W REXBURG, ID 83440 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $12K | — | $12K | 2.24% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK INK SOLUTIONS | 2240 E 25TH ST IDAHO FALLS, ID 83402 | WILLAMETTE DENTAL OF IDAHO | $11K | — | $11K | 5.00% |
| CASTLE LAKE INSURANCE LLC3 | P.O. BOX 2751 IDAHO FALLS, ID 83403 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $14K | — | $14K | 7.50% |
| INTERMOUNTAIN INSURANCE SERVICES3 | 136 S 1ST W REXBURG, ID 83440 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $14K | — | $14K | 7.50% |
| EMPLOYEE FAMILY PROTECTION INC3 | PO BOX 1237 GLASTONBURY, CT 06033 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $26K | — | $26K | 18.33% |
| STEVEN RAY GRIFFIN3 | 2000 MORRIS AVE STE 1400 BIRMINGHAM, AL 35203 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 0.74% |
| INTERMOUNTAIN INSURANCE SERVICES3 | 136 S 1ST W REXBURG, ID 83440 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $774 | — | $774 | 0.55% |
| CASTLE LAKE INSURANCE LLC3 | P.O. BOX 2751 IDAHO FALLS, ID 83403 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $560 | — | $560 | 0.40% |
| MATTHEW B WALDRAM3 | PO BOX 2751 IDAHO FALLS, ID 83403 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $460 | — | $460 | 0.33% |
| JAMES H. VAN EPPS3 Filed as: JAMES H VAN EPPS | 10930 CRABAPPLE RD STE 206 ROSWELL, GA 30075 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $329 | — | $329 | 0.23% |
| CHARLES D. BLOCK3 Filed as: CHARLES D BLOCK | 648 VILLAGE PARK DR UNIT 208 WILMINGTON, NC 28405 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $329 | — | $329 | 0.23% |
| EMPLOYEE FAMILY PROTECTION INC3 | PO BOX 1237 GLASTONBURY, CT 06033 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $8K | — | $8K | 14.39% |
| STEVEN RAY GRIFFIN3 | 2000 MORRIS AVE STE 1400 BIRMINGHAM, AL 35203 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $344 | — | $344 | 0.61% |
| INTERMOUNTAIN INSURANCE SERVICES3 | 136 S 1ST W REXBURG, ID 83440 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $231 | — | $231 | 0.41% |
| CASTLE LAKE INSURANCE LLC3 | PO BOX 2751 IDAHO FALLS, ID 83403 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $173 | — | $173 | 0.31% |
| MATTHEW B WALDRAM3 | PO BOX 2751 IDAHO FALLS, ID 83403 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $116 | — | $116 | 0.21% |
| JAMES H. VAN EPPS3 Filed as: JAMES H VAN EPPS | 10930 CRABAPPLE RD STE 206 ROSWELL, GA 30075 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $68 | — | $68 | 0.12% |
| CHARLES D. BLOCK3 Filed as: CHARLES D BLOCK | 648 VILLAGE PARK DR, UNIT 208 WILMINGTON, NC 28405 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $68 | — | $68 | 0.12% |
| MATTHEW B WALDRAM3 | P.O. BOX 2751 IDAHO FALLS, ID 83403 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $508 | — | $508 | 14.99% |
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 | 1,260 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,260 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF IDAHO | 945 | $1.1M |
| Life insurance(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,260 | $770K |
| Short-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,260 | $532K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,260 | $529K |
| Stop-loss / reinsurancereinsurance | GERBER LIFE | 2,551 | $1.1M |
| Other(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,260 | $855K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,551 | — |
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.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.