Filings through .
History & trajectory Charts need 2 or more years. This plan has 10 years on file. Pro shows premium, premium per covered life, covered lives and carrier and broker share for every year.
See pricingPremium per covered life exceeds 2x the peer median for this NAICS and size cohort. The plan has rich benefits or a bad rate.
The Schedule A insurance contracts show who carries the risk, for which benefits and for how many people.
| Carrier | Coverage | Premium |
|---|---|---|
Stop-loss | Stop-loss | |
Broker: Leavitt Great West Ins Svcs LLC Dental | Dental | |
Vision | Vision |
Premium, covered lives, retention, contract number and renewal month for each carrier are on Pro.
See premium, retention and renewal dates for 3 contracts with Pro. Pro is free for 7 days and then costs $49 a month.
These benefits are declared on the Form 5500 main form. A ✓ means the benefit also has a Schedule A insurance contract. Without one, plan assets or a Schedule C TPA fund the benefit.
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 222 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 222 | Active, retired or separated, and beneficiaries. Dependents are not counted. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL INSURANCE COMPANY | 192 | $78K |
| Vision | VISION SERVICE PLAN | 222 | $7K |
| Stop-loss / reinsurancereinsurance | BERKLEY ACCIDENT & HEALTH | 222 | $419K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 222 | - |
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 instead of this filer's headcount. We show the row, but it does not count the people in this plan.
Brokers paid through Schedule A and service providers paid through Schedule C.
| Broker | Commissions |
|---|---|
Carrier: Delta Dental Insurance Company |
Commissions, fees, broker address and the carrier each broker is paid through are on Pro.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| LEAGUE SERVICE GROUP EIN 81-0605864 TRUSTEE | Trustee (bank, trust company, or similar financial institution) Service code 21 | 101 N RODNEY HELENA, MT 59601 | $233K |
| LEAVITT GROUP EIN 57-1195029 NONE | Consulting (general) Service code 16 | 3390 COLTON DRIVE, STE A HELENA, MT 59602 | $60K |
| SMITH RX EIN 81-1489804 NONE | Claims processing Service code 12 | 300 BRANNAN ST STE 601 SAN FRANCISCO, CA 94107 | $38K |
| FIDUCIARY RISK MANAGEMENT EIN 47-4131554 NONE | Legal Service code 29 | PO BOX 955 MENOMONEE FALLS, WI 83052 | $23K |
| HEALTH JOY EIN 46-5722012 CONSULTING | Consulting (general) Service code 16 | 215 W SUPERIOR ST., STE 500 CHICAGO, IL 60654 | $22K |
| TAKE CONTROL, INC. EIN 27-5492229 NONE | Consulting (general) Service code 16 | PO BOX 9132 MISSOULA, MT 59807 | $19K |
| EBMS EIN 81-0391256 NONE | Claims processing Service code 12 | PO BOX 21367 BILLINGS, MT 59104 | $14K |
| RELIANCE STANDARD EIN 36-0883760 NONE | Insurance agents and brokers Service code 22 | 1700 MARKET STREET, SUITE 1200 PHILADELPHIA, PA 191033938 | $13K |
| DOUGLAS WILSON AND COMPANY P.C. EIN 81-0446334 NONE | Accounting (including auditing) Service code 10 | PO BOX 2845 GREAT FALLS, MT 59403 | $13K |
| HEALTH RISK STRATEGIES, LLC EIN 41-1979502 NONE | Actuarial Service code 11 | 6804 BRITTANY ROAD EDINA, MN 55435 | $10K |
| CPI QUALIFIED PLAN CONSULTANTS, INC EIN 48-1205033 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | 5910 MINERAL POINT ROAD MADISON, WI 53705 | $8K |
This section shows how the plan is funded and what that means for risk.
Welfare charges, retention and retention rate (the carrier margin on this plan) are on Pro.
2 contacts
11 filings · 2015 to 2025