| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MST INSURANCE SOLUTIONS, INC.3 Filed as: MST INSURANCE AGENCY | 3451 E. COPPER POINT DR., STE 201 MERIDIAN, ID 83642 | QBE INSURANCE | $4K | $0 | $4K | 2.00% |
| MST INSURANCE SOLUTIONS, INC.3 Filed as: MST INSURANCE AGENCY | 3451 E. COPPER POINT DR., STE 201 MERIDIAN, ID 83642 | WILLAMETTE DENTAL OF IDAHO. INC. | $2K | $0 | $2K | 3.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| M S ADMINISTRATIVE SERVICES, INC. EIN 82-0380872 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $52K |
| WILLAMETTE DENTAL EIN 93-1253100 DENTAL ADMIN | Claims processing Service code 12 | — | $51K |
| MST INSURANCE AGENCY EIN 82-0382503 INSURANCE AGENT | Insurance agents and brokers Service code 22 | — | $40K |
| STRATOSE EIN 26-1790538 PPO NETWORK | Claims processing Service code 12 | — | $7K |
| IDAHO DEPARTMENT OF INSURANCE EIN 82-6000952 IMMUNIZATION ASSESSMENT | 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 | 175 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 176 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | QBE INSURANCE | 176 | $189K |
| Dental(2 contracts, 2 carriers) | QBE INSURANCE | 176 | $240K |
| Prescription drug | QBE INSURANCE | 176 | $189K |
| Stop-loss / reinsurancereinsurance | QBE INSURANCE | 176 | $189K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 176 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.