| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PERVIDIO BENEFITS SERVICES LLC3 | P.O. BOX 273 COLBERT, WA 99005 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 8.00% |
| PERVIDIO BENEFITS SERVICES LLC3 | P.O. BOX 273 COLBERT, WA 99005 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $574 | — | $574 | 4.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BOULDER ADMINISTRATION SERVICES EIN 20-3818605 THIRD PARTY ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | P.O. BOX 1046 BOULDER, MT 59632 | $53K |
| BG SUMMIT LLC EIN 88-2365748 THIRD PARTY ADMINISTRTAOR | Contract Administrator; Claims processing Service code 12 | P.O. BOX 1046 BOULDER, MT 59632 | $17K |
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 | 117 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 117 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 127 | $11K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 127 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 127 | — |
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.