| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 | 360 E VINE ST., STE. 200 LEXINGTON, KY 40507 | BLUECROSS BLUESHIELD OF MONTANA | $117K | $0 | $117K | 3.53% |
| JACK WILKINSON3 | 2300 RENAISSANCE BLVD. KING OF PRUSSIA, PA 19406 | RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF AMERICA | $24K | $0 | $24K | 10.00% |
| MARSH & MCLENNAN AGENCY LLC3 | 360 E VINE ST. LEXINGTON, KY 40507 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $0 | $7K | 16.36% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 70 WEST POINT, GA 31833 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $801 | $801 | 1.91% |
| MARSH & MCLENNAN AGENCY LLC3 | 360 E VINE ST. LEXINGTON, KY 40507 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 13.59% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 70 WEST POINT, GA 31833 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $469 | $469 | 1.91% |
| MARSH & MCLENNAN AGENCY LLC3 | 413 NORTH SHORE DRIVE SW KNOXVILLE, TN 37919 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $703 | $2K | 14.12% |
| CASSANDRA GREEN3 Filed as: CASSANDRA PRINKE | 25825 N MOON BLOSSUM LANE PHOENIX, AZ 85083 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $268 | $0 | $268 | 10.21% |
| MEADOR ENTERPRISES LLC3 | 1341 W CORAL REEF DR GILBERT, AZ 85233 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $178 | $0 | $178 | 6.78% |
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 | 239 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 242 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF MONTANA | 559 | $3.3M |
| Dental(2 contracts, 2 carriers) | RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF AMERICA | 425 | $262K |
| Vision(2 contracts, 2 carriers) | RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF AMERICA | 425 | $262K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 85 | $42K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 24 | $25K |
| Prescription drug | BLUECROSS BLUESHIELD OF MONTANA | 559 | $3.3M |
| Other(4 contracts, 4 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 190 | $62K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 559 | — |
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.