| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CUSTOM INSURANCE SPECIALISTS INC3 | 886 E 3200 N KAMAS, UT 84036 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $33K | $6K | $38K | 10.52% |
| USI INSURANCE SERVICES LLC3 | 100 SUMMIT LAKE DR VALHALLA, NY 10595 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $31K | $21 | $31K | 8.53% |
| JILL HUGHES3 | 6510 TAMARA DRIVE SALT LAKE CITY, UT 84129 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12K | $528 | $13K | 3.46% |
| DESIREE ROBERTSON3 | 5691 S STONE BLUFF WAY TAYLORSVILLE, UT 84118 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11K | $227 | $11K | 3.03% |
| NELLYN COX3 | 15825 EAST SUNFLOWER DR FOUNTAIN HILLS, AZ 85268 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $374 | — | $374 | 0.10% |
| PREMIER WORKSITE SOLUTIONS INC3 | 112 NW 114TH ST VANCOUVER, WA 98685 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | $8 | $16 | 0.00% |
| BENEFITS BY DESIGN INC3 | 2101 NE 279TH ST RIDGEFIELD, WA 98642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | $5 | $16 | 0.00% |
| MARK J ROBISON3 | 1255 KIENAS ROAD KALISPELL, MT 59901 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | — | $13 | 0.00% |
| WORKSITE BENEFITS GROUP INC3 | 112 NW 114TH ST VANCOUVER, WA 98685 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $4 | $8 | 0.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $24K | $31 | $24K | 12.99% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | — | $1K | $1K | 0.66% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | — | $924 | $924 | 0.51% |
| USI INSURANCE SERVICES LLC3 | 1100 E 6600 S STE 280 SALT LAKE CITY, UT 841065031 | AMERITAS LIFE INSURANCE CORP | $3K | — | $3K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| REGENCE BLUESHIELD OF IDAHO, INC. EIN 82-0206874 CLAIMS PROCESSING SERVICE | Claims processing; Insurance brokerage commissions and fees; Non-monetary compensation; Direct payment from the plan; Float revenue; Contract Administrator; Other services Service code 12 | — | $455K |
| AMERITAS LIFE INSURANCE CORP EIN 47-0098400 CONTRACT ADMINISTRATOR | Contract Administrator; Insurance agents and brokers; Insurance brokerage commissions and fees Service code 13 | PO BOX 81889 LINCOLN, NE 685011889 | $40K |
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 | 449 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 454 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | REGENCE BLUESHIELD OF IDAHO, INC. | 1,437 | $674K |
| Dental | AMERITAS LIFE INSURANCE CORP | 449 | $0 |
| Vision | AMERITAS LIFE INSURANCE CORP | 449 | $0 |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 899 | $547K |
| Stop-loss / reinsurancereinsurance | REGENCE BLUESHIELD OF IDAHO, INC. | 1,437 | $674K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 899 | $182K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,437 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.