| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MONTANA AUTOMOBILE DEALERS ASSOC4 Filed as: MONTANA AUTOMOBILE DEALERS ASS | 501 N SANDERS ST HELENA, MT 59601 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $0 | $6K | 16.61% |
| MONTANA AUTOMOBILE DEALERS ASSOC4 | 501 N. SANDERS STREET HELENA, MT 59601 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 18.80% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPLOYEE BENEFIT MANAGEMENT SERVICE EIN 81-0391256 THIRD PARTY ADMIN | Contract Administrator Service code 13 | — | $168K |
| IT STARTS WITH ME EIN 20-1378738 WELLNESS SCREENINGS | Direct payment from the plan Service code 50 | — | $102K |
| MTADA MANAGEMENT FEES | Direct payment from the plan Service code 50 | 501 N SANDERS HELENA, MT 59601 | $73K |
| ALIGNED BUSINESS SOLTIONS CONSULTING | Consulting (general); Insurance services Service code 16 | 6889 HOFFERBER ROAD SHEPHERD, MT 59079 | $34K |
| EMPLOYEE BENEFIT MGMT SERVICES EIN 81-1391256 UTILIZATION REV | Direct payment from the plan; Other services; Other fees Service code 49 | — | $30K |
| INTERWEST HEALTH EIN 84-1375849 PPO | Other services Service code 49 | — | $25K |
| LEAVITT GREAT WEST EIN 26-0576978 CONSULTING | Consulting (general); Insurance services Service code 16 | — | $24K |
| MEDICAL REHABILITATION CONSULTANTS EIN 91-1448997 PPO | Other services Service code 49 | — | $19K |
| JCCS, PC EIN 81-0348775 AUDITOR | Accounting (including auditing) Service code 10 | — | $17K |
| DEPARTMENT OF THE TREASURY TAXING AUTHORITY | Other fees Service code 99 | INTERNAL REVENUE SERVICE CINCINNATI, OH 459990009 | $9K |
| SMITH LAW FIRM EIN 81-0481142 LEGAL | Legal Service code 29 | — | $7K |
| FIDUCIARY RISK MANAGEMENT LEGAL | Legal Service code 29 | PO BOX 955 MENOMONEE FALLS, WI 530520955 | $7K |
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 | 653 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 653 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 657 | $22K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 643 | $38K |
| Stop-loss / reinsurancereinsurance | COMPANION LIFE INSURANCE COMPANY | 1,106 | $166K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 643 | $44K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,106 | — |
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."
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.