| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MYRIAD BENEFITS INC3 Filed as: MYRIAD BENEFITS, LLC | P.O. BOX 370 MERIDIAN, ID 83680 | DELTA DENTAL OF IDAHO | $6K | — | $6K | 5.00% |
| TIERNEY CONSULTING, INC | 2113 W PARKSTONE CT MERIDIAN, ID 836468200 | VISION SERVICE PLAN | $1K | — | $1K | 4.64% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| KEY BENEFIT ADMINISTRATORS, INC. EIN 35-1450364 NONE | Contract Administrator Service code 13 | — | $60K |
| DELTA DENTAL OF IDAHO EIN 82-0299431 NONE | Contract Administrator Service code 13 | P.O. BOX 2870 BOISE, ID 83701 | $19K |
| AMERICA HEALTH DATA INSTITUTE EIN 35-2048379 NONE | Contract Administrator Service code 13 | — | $11K |
| IDAHO PHYSICIANS NETWORK EIN 82-0462950 NONE | Contract Administrator Service code 13 | — | $10K |
| INSURANCE NETWORK AMERICA EIN 82-0417249 NONE | Contract Administrator Service code 13 | — | $10K |
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 | 203 | 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) | 203 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF IDAHO | 203 | $129K |
| Vision | VISION SERVICE PLAN | 135 | $31K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 203 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.