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| Provider | Services | Address | Compensation |
|---|---|---|---|
| LUMINARE HEALTH EIN 35-1846036 CONTRACT ADMINISTRATOR | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing Service code 12 | PO BOX 2920 CLINTON, IA 52733 | $888K |
| LEGALSHIELD EIN 73-1016729 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 1 PREPAID WAY ADA, OK 74820 | $85K |
| COMPSYCH EIN 36-3272141 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 455 NORTH CITYFRONTT PLAZA DRIVE 13TH FLOOR CHICAGO, IL 60611 | $66K |
| BLUECROSS BLUESHIELD OF MONTANA EIN 13-1837418 CONTRACT ADMINISTRATOR | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Contract Administrator Service code 12 | PO BOX 4309 HELENA, MT 59604 | $0 |
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 | 6,642 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 78 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 6,720 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | BLUECROSS BLUESHIELD OF MONTANA | 5,836 | $2.6M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 5,442 | $638K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,288 | $607K |
| Stop-loss / reinsurancereinsurance | RELIASTAR LIFE INSURANCE COMPANY | 6,526 | $2.1M |
| Other(5 contracts, 3 carriers) | UNUM INSURANCE COMPANY | 5,442 | $862K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 6,526 | — |
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.