| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WELLS FARGO INSURANCE SERVICES3 | 1300 SW 5TH AVENUE, SUITE 500 PORTLAND, OR 97201 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $22K | — | $22K | 7.65% |
| MATTECHECK & ASSOCIATES3 Filed as: MATTECHECK AND ASSOCIATES, INC. | 610 SW ALDER STREET, SUITE 310 PORTLAND, OR 97205 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $4K | — | $4K | 5.99% |
| THOMAS C SMITH3 Filed as: THOMAS C. SMITH | 2928 FOSTER CREIGHTON DRIVE NASHVILLE, TN 37204 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 2.40% |
| WELLS FARGO INSURANCE SERVICES3 | 1300 SW 5TH AVENUE, SUITE 500 PORTLAND, OR 97201 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 1.77% |
| WELLS FARGO INSURANCE SERVICES3 | 600 HIGHWAY 169 SOUTH, 18TH FLOOR SAINT LOUIS PARK, MN 55426 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 11.98% |
| WOHLMAN AND TOSCHI, INC.3 | 925 FOURTH AVENUE, SUITE 3200 SEATTLE, WA 98104 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $40 | — | $40 | 0.81% |
| BARRY ROBERT MOORE3 | 2761 GLENN ABBEY CIRCLE SANDY, UT 84093 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $30 | — | $30 | 0.61% |
| MURRAY BRADY3 | 6330 SOUTH 3000 E, SUITE 600 SALT LAKE CITY, UT 84121 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | — | $16 | $16 | 0.32% |
| TODD A. REID3 | 6340 SOUTH 3000 EAST, SUITE 500 SALT LAKE CITY, UT 84121 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $4 | — | $4 | 0.08% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS OF IDAHO HEALTH SERVICE EIN 82-0344294 CONTRACT ADMINISTRATOR | Claims processing Service code 12 | — | $269K |
| WEBTPA EMPLOYER SERVICES, INC. EIN 75-2611444 CONTRACT ADMINISTRATOR | Claims processing Service code 12 | — | $214K |
| MEDIMPACT HEALTHCARE SYSTEMS, INC. EIN 33-0567651 CONTRACT ADMINISTRATOR | Claims processing Service code 12 | — | $41K |
| EIDE BAILLY EIN 45-0250958 AUDITOR | Accounting (including auditing) Service code 10 | — | $23K |
| NAVIA BENEFITS EIN 33-0567651 CONTRACT ADMINISTRATOR | Accounting (including auditing) Service code 10 | — | $15K |
| AMERITAS LIFE INSURANCE CORPORATION EIN 47-0098400 CONTRACT ADMINISTRATOR | Claims processing Service code 12 | — | $9K |
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 | 937 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 937 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | WILLAMETTE DENTAL OF IDAHO, INC. | 77 | $28K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 937 | $293K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 937 | $293K |
| Long-term disability(3 contracts, 3 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 937 | $318K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 845 | $857K |
| Other(5 contracts, 5 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 937 | $383K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 937 | — |
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.