| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 606036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $704 | $704 | 0.05% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA DENTAL OF IDAHO EIN 82-0299431 PLAN ADMINISTRATOR | Plan Administrator Service code 14 | — | $4.4M |
| BLUE CROSS OF IDAHO HEALTH SERVICE EIN 82-0344294 PLAN ADMINISTRATION | Plan Administrator Service code 14 | — | $3.2M |
| PEAK1 EIN 37-1668953 CLAIMS PROCESSING | Claims processing Service code 12 | — | $87K |
| CVS CAREMARK CVS PARMACY, INC EIN 05-0340626 CLAIMS PROCESSING | Claims processing Service code 12 | — | $14K |
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 | 4,177 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 604 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 4,781 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | WILLAMETTE DENTAL OF IDAHO, INC. | 1,447 | $629K |
| Vision(2 contracts) | VISION SERVICE PLAN | 4,459 | $775K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 4,114 | $2.5M |
| Long-term disability | CIGNA LIFE INSURANCE COMPANY OF NORTH AMERICA | 4,094 | $1.4M |
| Other(2 contracts) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 4,243 | $4.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,459 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.