Form 5500 · Employee benefit plan · IDAHO FALLS, ID
MOUNTAIN VIEW HOSPITAL LLC
The filing calls this plan MOUNTAIN VIEW HOSPITAL LLC EMPLOYEE BENEFIT PLAN.
MOUNTAIN VIEW HOSPITAL LLC of IDAHO FALLS, ID spreads its employee benefits across 6 insurance carriers, according to its Form 5500 Schedule A. Its broker of record is CARLOS APONTE. Coverage is written through AMERICAN FIDELITY ASSURANCE COMPANY and 5 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 82-0516012 · plan 501 · plan year 2024, filed Sep 24, 2025
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354 other employer plans in Idaho have policy years ending in December. See the full list on the renewal calendar, or ask for it in Claude or ChatGPT.
How this plan is funded
Self-funded as reported
The filing reports a stop-loss contract and no medical premium, which is what a plan that pays its own claims reports.
A stop-loss policy appears on a Form 5500 only when the plan itself is the beneficiary, or the premiums are paid from plan money. Many employers buy stop-loss and never report it here. So a plan with no stop-loss on its filing may still have it.
Benefits declared on this filing
Also declared: other welfare.
Declared benefits are the plan’s own line 8b codes on Form 5500. “Not on Schedule A” means no insured contract for that line appears on this filing. That usually means the benefit is self-funded, or it sits under a different plan number.
Where a line has more than one insured contract, the carrier and the covered figure are the largest contract's by premium. The contracts are not added up: a pharmacy carve-out and the medical carrier beside it cover the same people.
Persons covered is the count the carrier filed for that policy at the end of its policy year, and it can include dependents. Participants is the plan's own count at the start of its plan year. The two count different people, so a covered figure can be larger.
Plan brief
Schedule A lists 9 insured contracts covering health, dental, vision, life, disability and stop-loss; the largest, with AMERICAN FIDELITY ASSURANCE COMPANY, covers 1,473 people.
The medical plan carries stop-loss coverage: the filing reports the plan paying its own health claims, with insured protection against large ones.
Reported premium across the insured contracts is $5,715,327, with $293,815 in disclosed broker commissions — about 5.1% of premium.
The health contract's policy period ended in December, while at least one ancillary line's policy period ended in April. The plan is on a split renewal cycle.
CARLOS APONTE is the broker of record on 1 of the 9 contracts; the rest name a different broker or none.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| BLUE CROSS OF IDAHO | Health, Vision | 4,208 | Jan 1, 2025 | $788,401 | $173,660 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA | Life | 1,424 | Jan 1, 2025 | $308,050 | $45,010 |
| DELTA DENTAL OF IDAHO | Dental | 1,263 | Jan 1, 2025 | $1,233,489 | $33,509 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA | Life, Disability | 2,291 | Jan 1, 2025 | $1,004,412 | $18,554 |
| WILLAMETTE DENTAL OF IDAHO, INC. | Dental | 766 | Jan 1, 2025 | $379,927 | $17,290 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA | — | 251 | Jan 1, 2025 | $81,960 | $3,706 |
| PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | Life | 87 | Jan 1, 2025 | $26,263 | $1,345 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA | Disability | 19 | Jan 1, 2025 | $4,940 | $741 |
| AMERICAN FIDELITY ASSURANCE COMPANY | Stop-loss | 1,473 | May 1, 2024 | $1,887,885 | $0 |
Covered = persons covered at policy year end, as filed on Schedule A for that policy — often certificates or one class, not the whole plan. Premium = the filing’s own premium/charges figure; “—” means not credibly reported.
Administrator and service providers
The plan administrator is from line 3a of the main form. We publish company names only.
Reported to OSHA
Reported to OSHA for 2025: 2,529 employees, 36 recordable cases, 107 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
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