| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC Filed as: PAYNE WEST INSURANCE INC. | PO BOX 30638 BILLINGS, MT 591070638 | DELTA DENTAL INSURANCE COMPANY | $6K | — | $6K | 10.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNE WEST INSURANCE | 2925 PALMER ST SUITE B MISSOULA, MT 59806 | UNUM | $4K | $1K | $5K | 20.00% |
| ASSUREX | 175 S THIRD ST STE 800 COLUMBUS, OH 43215 | UNUM | — | — | $0 | 0.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNEWEST INSURANCE INC. | 2925 PALMER ST SUITE B MISSOULA, MT 59806 | UNUM | $3K | $748 | $3K | 22.00% |
| ASSUREX | 175 S THIRD ST STE 800 COLUMBUS, OH 43215 | UNUM | — | — | $0 | 0.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNEWEST INSURANCE INC. | PO BOX 30638 BILLINGS, MT 591070638 | VISION SERVICE PLAN | $809 | — | $809 | 6.94% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNE WEST INSURANCE | 2925 PALMER ST STE B MISSOULA, MT 59806 | UNUM | $964 | $221 | $1K | 26.77% |
| ASSUREX | 175 S THIRD ST STE 800 COLUMBUS, OH 43215 | UNUM | — | — | $0 | 0.00% |
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 | 199 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MONTANA | 265 | $1.4M |
| Dental | DELTA DENTAL INSURANCE COMPANY | 105 | $62K |
| Vision | VISION SERVICE PLAN | 67 | $12K |
| Life insurance(2 contracts) | UNUM | 199 | $41K |
| Short-term disability | UNUM | 14 | $4K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MONTANA | 265 | $1.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 265 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.