| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HCC LIFE INSURANCE COMPANY3 | 225 TOWN PARK DRIVE, SUITE 350 KENNESAW, GA 301445509 | TOKIO MARINE HCC | — | — | $0 | 0.00% |
| INTERMOUNTAIN INSURANCE SERVICES3 | 136 S 1ST W REXBURG, ID 83440 | DELTA DENTAL OF IDAHO | $32K | — | $32K | 3.11% |
| CASTLE LAKE INSURANCE LLC3 | 1601 ANTLER DRIVE IDAHO FALLS, ID 83404 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 1.28% |
| INTERMOUNTAIN INSURANCE SERVICES3 | 136 S 1ST W REXBURG, ID 83440 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 1.28% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK INK SOLUTIONS | 2240 E 25TH ST IDAHO FALLS, ID 83402 | WILLAMETTE DENTAL OF IDAHO | $9K | — | $9K | 4.13% |
| CASTLE LAKE INSURANCE LLC3 | P.O. BOX 2751 IDAHO FALLS, ID 83403 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $15K | — | $15K | 7.50% |
| INTERMOUNTAIN INSURANCE SERVICES3 | 136 S 1ST W REXBURG, ID 83440 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $15K | — | $15K | 7.50% |
| EMPLOYEE FAMILY PROTECTION INC3 | PO BOX 1237 GLASTONBURY, CT 06033 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 3.22% |
| INTERMOUNTAIN INSURANCE SERVICES3 | 136 S 1ST W REXBURG, ID 83440 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 1.04% |
| CASTLE LAKE INSURANCE LLC3 | 1601 ANTLER DR IDAHO FALLS, ID 83404 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $949 | — | $949 | 0.90% |
| STEVEN RAY GRIFFIN3 | 2000 MORRIS AVE STE 1400 BIRMINGHAM, AL 35203 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $871 | — | $871 | 0.83% |
| MATTHEW B WALDRAM3 | PO BOX 2751 IDAHO FALLS, ID 83403 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $230 | — | $230 | 0.22% |
| JAMES H. VAN EPPS3 Filed as: JAMES H VAN EPPS | 10930 CRABAPPLE RD STE 206 ROSWELL, GA 30075 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $98 | — | $98 | 0.09% |
| CHARLES D. BLOCK3 Filed as: CHARLES D BLOCK | 648 VILLAGE PARK DR UNIT 208 WILMINGTON, NC 28405 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $98 | — | $98 | 0.09% |
| EMPLOYEE FAMILY PROTECTION INC3 | PO BOX 1237 GLASTONBURY, CT 06033 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 3.60% |
| INTERMOUNTAIN INSURANCE SERVICES3 | 136 S 1ST W REXBURG, ID 83440 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $258 | — | $258 | 0.66% |
| STEVEN RAY GRIFFIN3 | 2000 MORRIS AVE STE 1400 BIRMINGHAM, AL 35203 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $228 | — | $228 | 0.58% |
| CASTLE LAKE INSURANCE LLC3 | 1601 ANTLER DR IDAHO FALLS, ID 83404 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $220 | — | $220 | 0.56% |
| MATTHEW B WALDRAM3 | PO BOX 2751 IDAHO FALLS, ID 83403 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $94 | — | $94 | 0.24% |
| 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 | 0.17% |
| 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 | 0.17% |
| MATTHEW B WALDRAM3 | P.O. BOX 2751 IDAHO FALLS, ID 83403 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 15.00% |
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 | 1,282 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,282 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF IDAHO | 1,043 | $1.2M |
| Life insurance(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,282 | $743K |
| Short-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,282 | $519K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,282 | $509K |
| Stop-loss / reinsurancereinsurance | TOKIO MARINE HCC | 1,252 | $1.5M |
| Other(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,282 | $809K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,282 | — |
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.