| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| G SCOTT COOKE3 Filed as: SCOTT PETERSON | 21926 43RD DRIVE SE BOTHELL, WA 98021 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $853 | $5K | 11.82% |
| RONALD JONES3 | 320 NANCY COURT MOSCOW, ID 83843 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $858 | $3K | 8.66% |
| DOUGLAS-MCCARTY INSURANCE SERVICES3 Filed as: DOUGLAS EDWARD VIESELMEYER | 14405 115TH AVENUE COURT EAST PUYALLUP, WA 98374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $390 | $1K | $2K | 3.96% |
| MEGAN ELIZABETH CASTO3 | 10340 CARNEY DRIVE SE OLYMPIA, WA 98501 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $445 | $2K | 3.84% |
| ZACHAREE KEITH SIAHPUSH3 | 33 SE 71ST AVENUE PORTLAND, OR 97215 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $190 | $12 | $202 | 0.50% |
| MJ INSURANCE3 Filed as: CARYL ESTES AND VARIOUS AGENTS | 15907 ASH WAY, SUITE C609 LYNNWOOD, WA 98087 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $10 | $0 | $10 | 0.02% |
| JODI MOYLAN3 | 19103 MERIDIAN EAST PUYALLUP, WA 98375 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $6 | $0 | $6 | 0.01% |
| G SCOTT COOKE3 Filed as: SCOTT PETERSON | 21926 43RD DRIVE SE BOTHELL, WA 98021 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $779 | $4K | 11.00% |
| RONALD JONES3 | 320 NANCY COURT MOSCOW, ID 83843 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $806 | $3K | 8.29% |
| DOUGLAS-MCCARTY INSURANCE SERVICES3 Filed as: DOUGLAS EDWARD VIESELMEYER | 14405 115TH AVENUE COURT EAST PUYALLUP, WA 98374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $365 | $1K | $2K | 3.91% |
| MEGAN ELIZABETH CASTO3 | 10340 CARNEY DRIVE SE OLYMPIA, WA 98501 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $412 | $1K | 3.74% |
| ZACHAREE KEITH SIAHPUSH3 | 33 SE 71ST AVENUE PORTLAND, OR 97215 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $168 | $11 | $179 | 0.47% |
| ANTONIO JOSE ANGELES3 Filed as: ANTONIO MICHAEL JAIME | 24345 252ND AVENUE SE MAPLE VALLEY, WA 98038 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $34 | $0 | $34 | 0.09% |
| JODI MOYLAN3 | 19103 MERIDIAN EAST PUYALLUP, WA 98375 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $17 | $0 | $17 | 0.04% |
| G SCOTT COOKE3 Filed as: SCOTT PETERSON | 21926 43RD DRIVE SE BOTHELL, WA 98021 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $536 | $3K | 12.05% |
| RONALD JONES3 | 320 NANCY COURT MOSCOW, ID 83843 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $510 | $2K | 8.13% |
| DOUGLAS-MCCARTY INSURANCE SERVICES3 Filed as: DOUGLAS EDWARD VIESELMEYER | 14405 115TH AVENUE COURT EAST PUYALLUP, WA 98374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $240 | $719 | $959 | 3.80% |
| MEGAN ELIZABETH CASTO3 | 10340 CARNEY DRIVE SE OLYMPIA, WA 98501 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $633 | $264 | $897 | 3.56% |
| DEBORAH VIESELMEYER & OTHER AGENTS3 Filed as: DEBORAH VIESELMEYER AND OTHER AGENT | 14405 115TH AVENUE COURT EAST PUYALLUP, WA 98374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $193 | $0 | $193 | 0.77% |
| RYAN G YOUNG3 Filed as: RYAN G. YOUNG | 801 NORTH NURSERY ROAD IRVING, TX 75061 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $175 | $0 | $175 | 0.69% |
| ZACHAREE KEITH SIAHPUSH3 | 33 SE 71ST AVENUE PORTLAND, OR 97215 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $109 | $7 | $116 | 0.46% |
| G SCOTT COOKE3 Filed as: SCOTT PETERSON | 21926 43RD DRIVE SE BOTHELL, WA 98021 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $252 | $2K | 8.08% |
| RONALD JONES3 | 320 NANCY COURT MOSCOW, ID 83843 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $922 | $258 | $1K | 5.46% |
| DOUGLAS-MCCARTY INSURANCE SERVICES3 Filed as: DOUGLAS EDWARD VIESELMEYER | 14405 115TH AVENUE COURT EAST PUYALLUP, WA 98374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $192 | $358 | $550 | 2.55% |
| MEGAN ELIZABETH CASTO3 | 10340 CARNEY DRIVE SE OLYMPIA, WA 98501 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $414 | $134 | $548 | 2.54% |
| ZACHAREE KEITH SIAHPUSH3 | 33 SE 71ST AVENUE PORTLAND, OR 97215 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $54 | $4 | $58 | 0.27% |
| CARYL ESTES3 | 15907 ASH WAY, SUITE C609 LYNNWOOD, WA 98087 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $22 | $0 | $22 | 0.10% |
| ANTONIO JOSE ANGELES3 Filed as: ANTONIO MICHAEL JAIME | 24345 252ND AVENUE SE MAPLE VALLEY, WA 98038 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $15 | $0 | $15 | 0.07% |
| BERG BENEFITS, INC.3 | PO BOX 66029 TACOMA, WA 98464 | PRINCIPAL LIFE INSURANCE COMPANY | $582 | $0 | $582 | 8.93% |
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 | 254 | 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) | 254 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(5 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 254 | $132K |
| Short-term disability(4 contracts) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 40 | $125K |
| Other(5 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 254 | $132K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 254 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.