| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COVENANT INSURANCE GROUP, INC.3 Filed as: COVENANT INSURANCE GROUP | 732 W COLLINS DR CASPER, WA 82601 | VISION SERVICE PLAN | $2K | — | $2K | 3.65% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ALLEGIANCE BENEFIT PLAN MANAGEMENT EIN 81-0400550 ADMINISTRATOR | Claims processing Service code 12 | — | $56K |
| MADER TSCHACHER PETERSON & CO., LLC EIN 83-0244838 NONE | Accounting (including auditing) Service code 10 | — | $10K |
| STARPOINT, LLC EIN 03-0507057 CASE MANAGEMENT | Claims processing Service code 12 | — | $6K |
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 | 230 | 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) | 230 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF WYOMING | 214 | $9K |
| Vision | VISION SERVICE PLAN | 199 | $52K |
| Life insurance | COMPANION LIFE | 234 | $491K |
| Stop-loss / reinsurancereinsurance | COMPANION LIFE | 234 | $491K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 234 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.