| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNEWEST INSURANCE, INC. | P.O. BOX 30638 BILLINGS, MT 59107 | HARTFORD LIFE AND ACCIDENT | $92K | $13K | $105K | 12.50% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNEWEST INSURANCE, INC. | P.O. BOX 30638 BILLINGS, MT 59107 | METROPOLITAN LIFE INSURANCE COMPANY | — | $25 | $25 | 0.01% |
| INTERMOUNTAIN INSURANCE SERVICES3 Filed as: INTERMOUNTAIN UNDERWRITERS, INC. | P.O. BOX 3018 MISSOULA, MT 59806 | NATIONAL UNION FIRE INS CO OF PITTSBURGH, PA | $17K | — | $17K | 10.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNEWEST INSURANCE, INC. | P.O. BOX 30638 BILLINGS, MT 59107 | VISION SERVICE PLAN | $7K | — | $7K | 5.00% |
| CHARLES D. BLOCK3 | 648 VILLAGE PARK DRIVE UNIT 208 WILMINGTON, NC 28405 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $587 | $8K | 6.74% |
| JAMES H. VAN EPPS3 Filed as: JAMES H VAN EPPS | 10930 CRABAPPLE ROAD, SUITE 206 ROSWELL, GA 30075 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $186 | $8K | 6.40% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNEWEST INSURANCE, INC. | 2925 PALMER STREET, SUITE B MISSOULA, MT 59806 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $387 | $7K | 5.68% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $532 | $104 | $636 | 8.98% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNEWEST INSURANCE, INC | 2925 PALMER STREET, SUITE B MISSOULA, MT 59806 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $19 | — | $19 | 0.27% |
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 | 1,327 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 16 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,343 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 702 | $141K |
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 2,802 | $1.3M |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 2,802 | $839K |
| Other(6 contracts, 5 carriers) | HARTFORD LIFE AND ACCIDENT | 2,802 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,802 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.