| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JAMES RAIOLA3 | — | BLUECROSS BLUE SHIELD OF MONTANA | $19K | — | $19K | 1.99% |
| THE JAMES B OSWALD COMPANY3 Filed as: JAMES J RAIOLA | 8 MULBERRY ROAD BRISTOL, RI 02809 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 9.65% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNEWEST INSURANCE INC | 811 NORTH COAST HIGHWAY NEWPORT, OR 97365 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $856 | $408 | $1K | 1.69% |
| BULFINCH GROUP INSURANCE AGENCY3 | 140 KENDRICK STREET C-1E NEEDHAM, MA 02494 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $485 | — | $485 | 0.65% |
| NORTHERN ROCKIES FINANCIAL GROUP3 | 1014 SOUTH AVENUE WEST MISSOULA, MT 59801 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $9 | — | $9 | 0.01% |
| BULFINCH GROUP INSURANCE AGENCY3 | 160 GOULD STREET #310 NEEDHAM, MA 02494 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2 | — | $2 | 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 | 101 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 104 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUE SHIELD OF MONTANA | 228 | $966K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 79 | $75K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 79 | $75K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 79 | $75K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 228 | — |
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.