| 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 | $2K | $188 | $2K | 5.24% |
| RONALD JONES3 Filed as: RONALD JONES AND OTHER AGENTS | 320 NANCY COURT MOSCOW, ID 83843 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $753 | $103 | $856 | 2.43% |
| MEGAN ELIZABETH CASTO3 | 10340 CARNEY DRIVE SE OLYMPIA, WA 98501 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $480 | $83 | $563 | 1.60% |
| DOUGLAS-MCCARTY INSURANCE SERVICES3 Filed as: DOUGLAS EDWARD VIESELMEYER | 14405 115TH AVENUE COURT EAST PUYALLUP, WA 98374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $284 | $103 | $387 | 1.10% |
| JOEL SAMANDARI LUCAS3 | 2129 SOUTH BELAIR DRIVE MOSES LAKE, WA 98837 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $233 | $42 | $275 | 0.78% |
| ZACHAREE KEITH SIAHPUSH3 | 33 SE 71ST AVENUE PORTLAND, OR 97215 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $52 | $7 | $59 | 0.17% |
| ANTONIO JOSE ANGELES3 Filed as: ANTONIO MICHAEL JAIME | 24345 252ND AVENUE SE MAPLE VALLEY, WA 98038 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $29 | $0 | $29 | 0.08% |
| G SCOTT COOKE3 Filed as: SCOTT PETERSON | 21926 43RD DRIVE SE BOTHELL, WA 98021 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $386 | $3K | 8.06% |
| MEGAN ELIZABETH CASTO3 | 10340 CARNEY DRIVE SE OLYMPIA, WA 98501 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $639 | $161 | $800 | 2.40% |
| LUIS EDUARDO CARDENAS3 | 26341 SE DUTHIE HILL ROAD ISSAQUAH, WA 98029 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $514 | $96 | $610 | 1.83% |
| RONALD JONES3 Filed as: RONALD JONES AND OTHER AGENTS | 320 NANCY COURT MOSCOW, ID 83843 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $512 | $52 | $564 | 1.69% |
| DOUGLAS-MCCARTY INSURANCE SERVICES3 Filed as: DOUGLAS EDWARD VIESELMEYER | 14405 115TH AVENUE COURT EAST PUYALLUP, WA 98374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $293 | $197 | $490 | 1.47% |
| JOEL SAMANDARI LUCAS3 | 2129 SOUTH BELAIR DRIVE MOSES LAKE, WA 98837 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $388 | $71 | $459 | 1.38% |
| ZACHAREE KEITH SIAHPUSH3 | 33 SE 71ST AVENUE PORTLAND, OR 97215 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $80 | $14 | $94 | 0.28% |
| G SCOTT COOKE3 Filed as: SCOTT PETERSON | 21926 43RD DRIVE SE BOTHELL, WA 98021 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $332 | $2K | 9.64% |
| MEGAN ELIZABETH CASTO3 | 10340 CARNEY DRIVE SE OLYMPIA, WA 98501 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $452 | $111 | $563 | 2.35% |
| JOEL SAMANDARI LUCAS3 | 2129 SOUTH BELAIR DRIVE MOSES LAKE, WA 98837 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $392 | $72 | $464 | 1.94% |
| DOUGLAS-MCCARTY INSURANCE SERVICES3 Filed as: DOUGLAS EDWARD VIESELMEYER | 14405 115TH AVENUE COURT EAST PUYALLUP, WA 98374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $223 | $141 | $364 | 1.52% |
| LUIS EDUARDO CARDENAS3 | 26341 SE DUTHIE HILL ROAD ISSAQUAH, WA 98029 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $295 | $55 | $350 | 1.46% |
| RONALD JONES3 | 320 NANCY COURT MOSCOW, ID 83843 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $322 | $17 | $339 | 1.42% |
| ZACHAREE KEITH SIAHPUSH & OTHR AGNT3 | 33 SE 71ST AVENUE PORTLAND, OR 97215 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $95 | $10 | $105 | 0.44% |
| G SCOTT COOKE3 Filed as: SCOTT PETERSON | 21926 43RD DRIVE SE BOTHELL, WA 98021 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $718 | $31 | $749 | 3.65% |
| RONALD JONES3 Filed as: RONALD JONES AND OTHER AGENTS | 320 NANCY COURT MOSCOW, ID 83843 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $364 | $31 | $395 | 1.92% |
| MEGAN ELIZABETH CASTO3 | 10340 CARNEY DRIVE SE OLYMPIA, WA 98501 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $179 | $15 | $194 | 0.95% |
| DOUGLAS-MCCARTY INSURANCE SERVICES3 Filed as: DOUGLAS EDWARD VIESELMEYER | 14405 115TH AVENUE COURT EAST PUYALLUP, WA 98374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $151 | $18 | $169 | 0.82% |
| RYAN G YOUNG3 Filed as: RYAN G. YOUNG | 801 NORTH NURSERY ROAD IRVING, TX 75061 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $157 | $0 | $157 | 0.76% |
| DEBORAH S GOLDEN3 Filed as: DEBORAH DENISE VIESELMEYER | 14405 115TH AVENUE COURT EAST PUYALLUP, WA 98374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $105 | $0 | $105 | 0.51% |
| CHRISTOPHER ROBERT BERRY3 | 9222 168TH STREET SE SNOHOMISH, WA 98296 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $45 | $0 | $45 | 0.22% |
| BERG BENEFITS, INC.3 | PO BOX 66029 TACOMA, WA 98464 | PRINCIPAL LIFE INSURANCE COMPANY | $561 | — | $561 | 9.85% |
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 | 226 | 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) | 226 | 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 | 226 | $119K |
| Short-term disability(4 contracts) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 33 | $113K |
| Other(5 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 226 | $119K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 226 | — |
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.