| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNEWEST INSURANCE INC | 545 SW 2ND STREET SUITE 101 CORVALLIS, OR 97333 | GUARDIAN LIFE INSURANCE OF AMERICA | $11K | $10K | $21K | 6.63% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNEWEST INSURANCE INC | 3289 GABEL RD BILLINGS, MT 59102 | UNUM LIFE INSURANCE OF AMERICA | $11K | $1K | $12K | 15.70% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNEWEST INSURANCE INC | 3289 GABEL RD BILLINGS, MT 59102 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $378 | $3K | 6.75% |
| ASSUREX4 | 175 SOUTH 3RD ST STE 800 COLUMBUS, OH 43215 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $310 | $310 | 0.62% |
| BLOCK, CHARLES, D4 | 648 VILLAGE PARK DR UNIT 208 WILMINGTON, NC 28405 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $207 | — | $207 | 0.42% |
| VAN EPPS, JAMES, H4 | 10930 CRABAPPLE RD, STE 206 ROSWELL, GA 30075 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $207 | — | $207 | 0.42% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNEWEST INSURANCE INC | 3289 GABEL RD BILLINGS, MT 59102 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $388 | $3K | 7.95% |
| BLOCK, CHARLES, D4 | 648 VILLAGE PARK DR UNIT 208 WILINGTON, NC 28405 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $544 | — | $544 | 1.38% |
| VAN EPPS, JAMES, H4 | 10930 CRABAPPLE RD STE 206 ROSWELL, GA 30075 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $544 | — | $544 | 1.38% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNEWEST INSURANCE INC | 3289 GABEL RD BILLINGS, MT 59102 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $341 | $3K | 15.56% |
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 | 490 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 494 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | GUARDIAN LIFE INSURANCE OF AMERICA | 422 | $312K |
| Vision | GUARDIAN LIFE INSURANCE OF AMERICA | 422 | $312K |
| Life insurance(3 contracts, 3 carriers) | UNUM LIFE INSURANCE OF AMERICA | 485 | $146K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MONTANA | 490 | $660K |
| Other(3 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 485 | $108K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 490 | — |
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."
No prospect flags tripped on this filing.