| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 181 E 5600 S, STE 240 SALT LAKE CITY, UT 84107 | VISION SERVICE PLAN | $28K | — | $28K | 17.44% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 3600 AMERICAN BLVD W SUITE 500 BLOOMINGTON, MN 55431 | SUN LIFE ASSURANCE COMPANY OF CANADA | $14K | $2K | $16K | 10.45% |
| STEALTH PARTNER GROUP LLC3 Filed as: STEALTH BENEFIT SOLUTIONS LLC DBA | 18940 N PIMA ROAD SUITE 210 SCOTTSDALE, AZ 85255 | SUN LIFE ASSURANCE COMPANY OF CANADA | $7K | $4K | $11K | 7.12% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MONTANA EIN 36-1236610 | Contract Administrator; Direct payment from the plan Service code 13 | — | $426K |
| BENEFIS HEALTH SYSTEM, INC. EIN 81-0232122 EMPLOYER | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 13 | — | $95K |
| WELLS FARGO BANK EIN 94-1347393 | Direct payment from the plan; Account maintenance fees Service code 50 | — | $32K |
| MOSS ADAMS LLP EIN 91-0189318 | Accounting (including auditing) Service code 10 | — | $12K |
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 | 1,664 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 16 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 17 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,697 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 1,955 | $158K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,637 | $153K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,955 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.