| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 | 1420 5TH AVENUE, SUITE 1500 SEATTLE, WA 98101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $45K | $17K | $62K | 13.76% |
| FMLASOURCE INC5 | 455 NORTH CITYFRONT PLAZA DRIVE 13TH FLOOR CHICAGO, IL 60611 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $7K | $7K | 1.56% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUECROSS BLUESHIELD OF MONTANA CLAIMS PROCESSING | Insurance services; Claims processing 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 15TH FLOOR SEATTLE, WA 98101 | $66K |
| PINION EIN 48-0567703 AUDIT SERVICES | Accounting (including auditing) Service code 10 | — | $15K |
| ETC LITE LLC EIN 81-4774505 CONSULTING | Insurance services Service code 23 | — | $6K |
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 | 456 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 460 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 468 | $453K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 468 | $453K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 468 | $453K |
| Stop-loss / reinsurancereinsurance | BLUECROSS BLUESHIELD OF MONTANA | 1,118 | $5.6M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 468 | $453K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,118 | — |
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.