| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 1420 5TH AVE STE 1500 SEATTLE, WA 98101 | BLUECROSS BLUESHIELD OF MONTANA | — | $45K | $45K | 0.87% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 401 UNION ST FL 31 SEATTLE, WA 98101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $26K | — | $26K | 10.00% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 1420 5TH AVE STE 1500 SEATTLE, WA 98101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $10K | $10K | 3.82% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 401 UNION ST FL 31 SEATTLE, WA 98101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $17K | $0 | $17K | 10.00% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 1420 5TH AVE STE 1500 SEATTLE, WA 98101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $6K | $6K | 3.76% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 401 UNION ST FL 31 SEATTLE, WA 98101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $16K | — | $16K | 10.00% |
| FMLASOURCE INC5 | 455 N CITYFRONT PLZ DR, 13TH FLOOR CHICAGO, IL 60611 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $9K | $9K | 5.50% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 1420 5TH AVE STE 1500 SEATTLE, WA 98101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $6K | $6K | 3.78% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | CONTINENTIAL AMERICAN INSURANCE COMPANY | $26K | — | $26K | 18.15% |
| CHRISTINE L EBY3 | 3210 TIZER RD HELENA, MT 59602 | CONTINENTIAL AMERICAN INSURANCE COMPANY | $18K | — | $18K | 12.67% |
| HOLLY A MARITA3 Filed as: HOLLY KRISTINE HALL | 2662 E UPPER HAYDEN LAKE RD HAYDEN, ID 838357185 | CONTINENTIAL AMERICAN INSURANCE COMPANY | $12K | — | $12K | 8.40% |
| KARI SCHALIN3 | 1324 CENTRAL AVE W, STE 13 GREAT FALLS, MT 59404 | CONTINENTIAL AMERICAN INSURANCE COMPANY | $5K | — | $5K | 3.75% |
| VERNON LINDSTRAND3 | 3908 16TH AVENUE SOUTH GREAT FALLS, MT 59405 | CONTINENTIAL AMERICAN INSURANCE COMPANY | $3K | — | $3K | 2.40% |
| JOSE CRUZ BLANCO3 | 18300 ARAGON LN, APT K MORGAN HILL, CA 95037 | CONTINENTIAL AMERICAN INSURANCE COMPANY | $192 | — | $192 | 0.13% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 401 UNION ST FL 31 SEATTLE, WA 98101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $11K | — | $11K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUECROSS BLUESHIELD OF MONTANA EIN 36-1236610 CLAIMS PROCESSING | Claims processing; Insurance services Service code 12 | PO BOX 7309 HELENA, MT 59604 | $6.7M |
| ALLIANT INSURANCE SERVICES EIN 33-0785439 CONSULTING | Plan Administrator Service code 14 | 1420 5TH AVENUE, 5TH FLOOR SEATTLE, WA 98101 | $71K |
| KCOE ISOM, LLP EIN 94-2222122 AUDIT SERVCIES | Accounting (including auditing) Service code 10 | — | $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 | 488 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 496 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 516 | $336K |
| Short-term disability(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 516 | $472K |
| Long-term disability | CONTINENTIAL AMERICAN INSURANCE COMPANY | 296 | $144K |
| Stop-loss / reinsurancereinsurance | BLUECROSS BLUESHIELD OF MONTANA | 1,206 | $5.2M |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 516 | $336K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,206 | — |
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.