| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNEWEST INSURANCE, INC. | 390 BRADLEY BLVD RICHLAND, WA 99352 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $20K | $0 | $20K | 5.77% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNEWEST INSURANCE INC | 2925 PALMER ST STE B MISSOULA, MT 59806 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | $0 | $3K | 5.00% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $1K | $1K | 1.75% |
| MARK S METTILLE3 | 422 WAUPONSEE ST MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $595 | $595 | 1.01% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNEWEST INSURANCE, INC. | — | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | $3K | $0 | $3K | 5.01% |
| SEE ATTACHED3 | — | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $666 | $5K | 12.24% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNEWEST INSURANCE, INC. | 2925 PALMER ST. STE B MISSOULA, MT 59806 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | $0 | $4K | 15.00% |
| MARK J MATSOCK & ASSOCIATES INC3 Filed as: MARK S METTILIE | 422 WAUPONSEE ST MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $438 | $438 | 1.71% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $433 | $433 | 1.69% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNEWEST INSURANCE, INC. | 2525 PALMER ST. STE B MISSOULA, MT 59808 | VISION SERVICE PLAN | $846 | $0 | $846 | 6.65% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNEWEST INSURANCE INC | 2925 PALMER ST STE B MISSOULA, MT 59806 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | $0 | $2K | 15.00% |
| MARK S METTILLE3 | 422 WAUPONSEE ST MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $206 | $206 | 1.71% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $204 | $204 | 1.69% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNEWEST INSURANCE INC | 2925 PALMER ST STE B MISSOULA, MT 59806 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $862 | $0 | $862 | 15.00% |
| MARK S METTILLE3 | 422 WAUPONSEE ST MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $103 | $103 | 1.79% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IA 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $98 | $98 | 1.71% |
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 | 102 | 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) | 102 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | 49 | $397K |
| Dental | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 83 | $59K |
| Vision | VISION SERVICE PLAN | 90 | $13K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 99 | $50K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 99 | $12K |
| Other(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 99 | $31K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 99 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.