| 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 & ACCIDENT INSURANCE COMPANY | $2K | $2K | $4K | 12.69% |
| RONALD JONES3 | 320 NANCY COURT MOSCOW, ID 83843 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $691 | $2K | 7.42% |
| MEGAN ELIZABETH CASTO3 | HOME OFFICE COLUMBIA, SC 29202 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $806 | $348 | $1K | 3.60% |
| DOUGLAS-MCCARTY INSURANCE SERVICES3 Filed as: DOUGLAS EDWARD VIESELMEYER | 14405 115TH AVENUE COURT EAST PUYALLUP, WA 98374 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $292 | $263 | $555 | 1.73% |
| ZACHAREE KEITH SIAHPUSH3 | 4412 RENTON AVENUE SOUTH SEATTLE, WA 98108 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $122 | $12 | $134 | 0.42% |
| ANTONIO JOSE ANGELES3 Filed as: ANTONIO MICHAEL JAIME | 24345 252ND AVENUE SE MAPLE VALLEY, WA 98038 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $40 | $0 | $40 | 0.12% |
| JODI MOYLAN3 | 19103 MERIDIAN EAST PUYALLUP, WA 98375 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $28 | $0 | $28 | 0.09% |
| G SCOTT COOKE3 Filed as: SCOTT PETERSON | 21926 43RD DRIVE SE BOTHELL, WA 98021 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $2K | $4K | 15.19% |
| RONALD JONES3 | 320 NANCY COURT MOSCOW, ID 83843 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $663 | $2K | 8.48% |
| MEGAN ELIZABETH CASTO3 | HOME OFFICE COLUMBIA, SC 29202 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $732 | $335 | $1K | 3.85% |
| DOUGLAS-MCCARTY INSURANCE SERVICES3 Filed as: DOUGLAS EDWARD VIESELMEYER | 14405 115TH AVENUE COURT EAST PUYALLUP, WA 98374 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $248 | $253 | $501 | 1.81% |
| ZACHAREE KEITH SIAHPUSH3 | 4412 RENTON AVENUE SOUTH SEATTLE, WA 98108 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $145 | $12 | $157 | 0.57% |
| ANTONIO JOSE ANGELES3 Filed as: ANTONIO MICHAEL JAIME | 24345 252ND AVENUE SE MAPLE VALLEY, WA 98038 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $47 | $0 | $47 | 0.17% |
| JOEL S LUCAS3 Filed as: JOEL SAMANDARI LUCAS AND OTHERS | 2129 SOUTH BELAIR DRIVE MOSES LAKE, WA 98837 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $21 | $0 | $21 | 0.08% |
| G SCOTT COOKE3 Filed as: SCOTT PETERSON | 21926 43RD DRIVE SE BOTHELL, WA 98021 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $2K | $5K | 21.98% |
| RONALD JONES3 | 320 NANCY COURT MOSCOW, ID 83843 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $934 | $3K | 13.08% |
| MEGAN ELIZABETH CASTO3 | HOME OFFICE COLUMBIA, SC 29202 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $909 | $471 | $1K | 5.72% |
| DOUGLAS-MCCARTY INSURANCE SERVICES3 Filed as: DOUGLAS EDWARD VIESELMEYER | 14405 115TH AVENUE COURT EAST PUYALLUP, WA 98374 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $276 | $355 | $631 | 2.62% |
| ZACHAREE KEITH SIAHPUSH3 | 4412 RENTON AVENUE SOUTH SEATTLE, WA 98108 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $165 | $17 | $182 | 0.75% |
| CARYL ESTES3 | 15907 ASH WAY, UNIT C609 LYNNWOOD, WA 98087 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $24 | $0 | $24 | 0.10% |
| ANTONIO JOSE ANGELES3 Filed as: ANTONIO MICHAEL JAIME | 24345 252ND AVENUE SE MAPLE VALLEY, WA 98038 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | $0 | $16 | 0.07% |
| BERG BENEFITS, INC.3 | 1804 WEST UNION AVENUE, SUITE 201 TACOMA, WA 98405 | SUN LIFE ASSURANCE COMPANY OF CANADA | $780 | $0 | $780 | 10.94% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 30339 | SUN LIFE ASSURANCE COMPANY OF CANADA | $0 | $65 | $65 | 0.91% |
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 | 229 | 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) | 229 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 229 | $31K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 20 | $24K |
| Other(4 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 229 | $91K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 229 | — |
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.