| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LEAVITT GROUP3 Filed as: LEAVITT GREAT WEST INS SVCS LLC | 2345 KING AVE W STE A BILLINGS, MT 59102 | DELTA DENTAL INSURANCE COMPANY | $4K | — | $4K | 15.00% |
| PEAK 1 ADMINISTRATION LLC3 Filed as: PEAK 1 ADMINISTRATION, LLC | 508 NW BLVD STE 200 COEUR DALENE, ID 83814 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 20.00% |
| LEAVITT GROUP3 Filed as: LEAVITT GREAT WEST INSURANCE | PO BOX 2518 BILLINGS, MT 591032518 | VISION SERVICE PLAN | $1K | — | $1K | 5.30% |
| FLIKKEMA INSURANCE INC3 | 7175 CHURCHILL RD MANHATTAN, MT 59741 | AFLAC | $486 | — | $486 | 5.75% |
| LEAVITT GROUP3 Filed as: LEAVITT GREAT WEST INSURANCE SERVIC | 2345 KING AVE W STE A BILLINGS, MT 59102 | AFLAC | $215 | — | $215 | 2.55% |
| SHAWN D SYVERSON3 | 81 8TH ST STE 12 BELGRADE, MT 59714 | AFLAC | $173 | — | $173 | 2.05% |
| CARLA A MCENTIRE3 Filed as: CARLA MCENTIRE | 81 8TH ST STE 12 BELGRADE, MT 59714 | AFLAC | $109 | — | $109 | 1.29% |
| CASEY DALE HOBSON3 | 13320 W REDNECK DR BOISE, ID 83713 | AFLAC | $11 | — | $11 | 0.13% |
| DAWN D SHEUE3 | PO BOX 3986 JACKSON, WY 83001 | AFLAC | $9 | — | $9 | 0.11% |
| EBMS5 | 2075 OVERLAND AVE BILLINGS, MT 59102 | EBMS RE/BENCHMARK INSURANCE CO. | $0 | $211K | $211K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MONTANA NONPROFIT ASSOCIATION EIN 73-1654969 PLAN SPONSOR | Other fees Service code 99 | — | $33K |
| HEALTHSERVE CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 1 N LAST CHANCE GULCH STE 4 HELENA, MT 59601 | $29K |
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 | 657 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 660 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL INSURANCE COMPANY | 60 | $27K |
| Vision | VISION SERVICE PLAN | 394 | $22K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 67 | $22K |
| Short-term disability | AFLAC | 4 | $8K |
| Stop-loss / reinsurancereinsurance | EBMS RE/BENCHMARK INSURANCE CO. | 874 | $0 |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 67 | $22K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 874 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.