So, how much in sales commissions are being paid to individual insurance agents who sell health insurance for Montana Blue Cross/Blue Shield?

The answer: An average of more than $100,000 per agent last year.

In fact, it's likely some agents are making as much as Blue Cross' top executives, who last year earned anywhere from $200,000 to $480,000 in salary, bonuses and other compensation.

The question about insurance-agent pay is one of several that arose in the wake of our three-part series on the cost of health insurance, which ran in the Aug. 5-6-7 editions of the Independent Record.

Reader reaction to the series was substantial, and, as usual, readers brought up many intriguing points and questions. This column responds to some of those comments.

Regarding insurance agent commissions, we reported in the story that Blue Cross paid out $15 million in sales commissions last year, or 3 percent of the entire premium dollar collected from customers.

It was asked how many individual agents split up that rather sizeable pie.

Blue Cross won't reveal the amounts paid to top agents, but did confirm it has about 120 agents selling its policies. That's an average of $125,000 paid per agent in sales commissions last year.

Sources familiar with the company also told the Lee Newspapers State Bureau that as much as 80 percent of commissions goes to about half the agents, who are the top sellers in the state. If that's so, some agents for Blue Cross are making well over $200,000 a year in commissions.

Blue Cross spokeswoman Linda McGillen says a single "agent'' isn't always one person, and may be a consultant or group of agents under one name. They may do a fair amount of work on behalf of a customers, she says, particularly clients who buy large group health policies.

"They are sort of the client advocate,'' she says.

Dirk Visser, president of a Blue Cross rival, Allegiance Life & Health Insurance Co. of Missoula, took a swipe at these commissions in the stories, saying commissions should be a flat fee, rather than a percentage of ever-increasing health insurance premiums.

Speaking of Visser, his comments on Blue Cross executive salaries drew a reaction from some Blue Cross employees, who felt he wasn't telling the entire story about his own compensation.

Visser said 2006 executive salaries at Allegiance, including his own, were less than the $180,000 earned by the lowest-paid of Blue Cross's top eight executives.

It was pointed out that Visser makes money from other sources, such as sales of his share of the company, a majority of which was sold this year to insurance giant Great-West of Colorado.

Visser says employees of Blue Cross (a nonprofit company) or anyone else are welcome to buy shares of a private company, as he has, and reap the rewards -- and risk failure.

At least one reader said if we're going to publicize the salaries of health insurance executives, in the context of health-care costs, we should do the same for top executives at major hospitals in the state.

Actually, we've done just that -- in a series that ran last September, focusing on costs at the state's large hospitals.

In fact, anyone who wants to find out salaries for top executives at Montana hospitals can go to www.guidestar.org, a Web site that tracks information on nonprofit organizations.

Most of Montana's major hospitals are nonprofits, and must file an annual 990 tax form with the Internal Revenue Service.

If you go to Guidestar, you can register for free and scroll through a nonprofit hospital's 990 forms, which list the salaries of not only the hospital's top executives, but also top-paid physicians on staff.

The Billings Clinic, for example, paid its chief executive officer, Nicholas Wolter, $554,000 in salary and benefits in 2005. That same year, St. Vincent Healthcare, Billings' other major hospital, paid its then-CEO Michelle Hood a shade over $500,000 in salary and benefits. Some surgeons at both hospitals made quite a bit more, topping out at just over $1 million.

Several readers blanched at the statement that Blue Cross premiums increased only 4 percent and 7 percent in 2004 and 2005, respectively, or less than the national average, saying their Blue Cross premiums had gone up quite a bit more.

It's given that some, or perhaps many, buyers of Blue Cross health insurance saw their premiums increase by greater amounts those years.

Blue Cross calculates the overall change in premiums by dividing the number of "members,'' or people insured, into the total dollar of premium collected. So, if Blue Cross sees a large surge in new customers for a given year, the average premium may increase slightly or even go down -- but the price for some policyholders may go up quite a bit.

Like any health insurance, your price depends on your age, the size of your group, how many claims your group may file, your health history, etc.

We mentioned in the stories that Montana Blue Cross is sponsoring a substantial health care forum in October. Blue Cross noted that hospitals and medical clinics in the state also are helping sponsor the event, scheduled Oct. 29-30 in Helena.

And, finally, we had a call from state Insurance Commissioner John Morrison, who pointed out that it's not accurate to say most Montanans and Americans with health insurance are covered by "private'' insurance.

In fact, huge swaths of the American population are either covered by the government or plans funded by the government, he said.

He's right. In Montana, for example, if you take all the people covered directly by government-financed plans, such as Medicare, and the families of government and school employees who have health insurance as part of their job, it's probably between 350,000 and 400,000 people. That's half or more than half of the approximately 775,000 Montanans who have some type of health coverage.

"It's a minority in America that have private health insurance,'' he said. "When you hear people in the health-care debate say that America is a private health-insurance country and that Canada is a socialized insurance country, that's not really accurate.''

Mike Dennison is a reporter at the Lee Newspapers State Bureau in Helena. He may be reached by telephone at (800) 525-4920 or (406) 443-4920 or by e-mail at:

mike.dennison@lee.net.