| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MONTANA HEALTH NETWORK, INC.3 Filed as: MONTANA HEALTH NETWORK INC | 519 PLEASANT STREET MILES CITY, MT 59301 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $9K | — | $9K | 8.31% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 650 EAST CARMEL DRIVE SUITE 400 CARMEL, ID 46032 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $5K | $7K | 6.70% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 650 EAST CARMEL DRIVE SUITE 400 CARMEL, IN 46032 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $2K | $2K | 2.19% |
| MONTANA HEALTH NETWORK, INC.3 Filed as: MONTANA HEALTH NETWORK INC | 519 PLEASANT STREET MILES CITY, MT 59301 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $7K | — | $7K | 8.30% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 650 EAST CARMEL DRIVE SUITE 400 CARMEL, ID 46032 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $4K | $6K | 6.70% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 650 EAST CARMEL DRIVE SUITE 400 CARMEL, IN 46032 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $2K | $2K | 2.06% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | VISION SERVICE PLAN | $2K | — | $2K | 3.75% |
| MONTANA HEALTH NETWORK, INC.3 Filed as: MONTANA HEALTH NETWORK INC | 519 PLEASANT STREET MILES CITY, MT 59301 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | 8.30% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 650 EAST CARMEL DRIVE SUITE 400 CARMEL, ID 46032 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $803 | $2K | $3K | 6.70% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEIT SERVICES INC | 650 EAST CARMEL DRIVE SUITE 400 CARMEL, IN 46032 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $951 | $951 | 2.01% |
| MONTANA HEALTH NETWORK, INC.3 Filed as: MONTANA HEALTH NETWORK INC | 519 PLEASANT STREET MILES CITY, MT 59301 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 8.30% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 650 EAST CARMEL DRIVE SUITE 400 CARMEL, ID 46032 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $207 | $609 | $816 | 6.71% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SE4RIVCES INC | 650 EAST CARMEL DRIVE SUITE 400 CARMEL, IN 46032 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $297 | $297 | 2.44% |
| MONTANA HEALTH NETWORK, INC.3 Filed as: MONTANA HEALTH NETWORK INC | 519 PLEASANT STREET MILES CITY, MT 59301 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $247 | — | $247 | 8.32% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 650 EAST CARMEL DRIVE SUITE 400 CARMEL, ID 46032 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $51 | $149 | $200 | 6.73% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 650 EAST CARMEL DRIVE SUITE 400 CARMEL, IN 46032 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $59 | $59 | 1.99% |
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 | 409 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 102 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 512 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 253 | $48K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 338 | $108K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 554 | $88K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 338 | $47K |
| Stop-loss / reinsurancereinsurance | MEDICAL MUTUAL OF OHIO | 290 | $853K |
| Other(3 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 338 | $123K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 554 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.