| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNEWEST INSURANCE INC | 811 NORTH COAST HIGHWAY NEWPORT, OR 97365 | GUARDIAN LIFE INSURANCE OF AMERICA | $9K | $11K | $20K | 6.77% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNEWEST INSURANCE INC | 2925 PALMER ST SUITE B MISSOULA, MT 59806 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $11K | $1K | $12K | 16.89% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNEWEST INSURANCE INC | 2925PALMER ST SUITE B MISSOULA, MT 59806 | PROVIDENT LIFE AND ACCIDENT INSURANCE | $3K | $493 | $3K | 5.37% |
| ASSUREX4 | STE 800 175 SOUTH 3RD STREET COLUMBUS, OH 43215 | PROVIDENT LIFE AND ACCIDENT INSURANCE | — | $638 | $638 | 1.06% |
| BLOCK, CHARLES, D4 Filed as: BLOCK, CHARLES D | UNIT 208 648 VILLAGE PARK DR WILMINGTON, NC 28405 | PROVIDENT LIFE AND ACCIDENT INSURANCE | $536 | $38 | $574 | 0.95% |
| VAN EPPS, JAMES, H4 Filed as: VAN EPPS, JAMES H | 10930 CRABAPPLE RD STE 206 ROSWELL, GA 30075 | PROVIDENT LIFE AND ACCIDENT INSURANCE | $536 | $2 | $538 | 0.89% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNEWEST INSURANCE INC | 2925 PALMER ST. SUITE B MISSOULA, MT 59806 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $476 | $3K | 6.77% |
| BLOCK, CHARLES, D4 Filed as: BLOCK, CHARLES D | UNIT 208 648 VILLAGE PARK DR WILLMINGTON, NC 28405 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $66 | $1K | 2.48% |
| VAN EPPS, JAMES, H4 Filed as: VAN EPPS, JAMES H | 10930 CRABAPPLE RD, STE 206 ROSWELL, GA 30075 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $10 | $1K | 2.36% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNEWEST INSURANCE INC | 2925 PALMER ST, SUITE B MISSOULA, MT 59806 | UNUM LIFE INSURANCE OF AMERICA | $3K | $362 | $3K | 17.00% |
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 | 457 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 462 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | GUARDIAN LIFE INSURANCE OF AMERICA | 388 | $294K |
| Vision | GUARDIAN LIFE INSURANCE OF AMERICA | 388 | $294K |
| Life insurance(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 475 | $152K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MONTANA | 461 | $463K |
| Other(3 contracts, 3 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE | 475 | $123K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 475 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.