| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LEAVITT GROUP Filed as: LEAVITT GREAT WEST INS SVCS LLC | 3390 COLTON DRIVE, STE A HELENA, MT 59602 | DELTA DENTAL INSURANCE COMPANY | $7K | — | $7K | 10.00% |
| 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 | $49K |
| EBMS EIN 81-0391256 NONE | Claims processing Service code 12 | PO BOX 21367 BILLINGS, MT 59104 | $47K |
| FIDUCIARY RISK MANAGEMENT EIN 47-4131554 NONE | Legal Service code 29 | PO BOX 955 MENOMONEE FALLS, WI 83052 | $35K |
| HEALTH JOY EIN 46-5722012 CONSULTING | Consulting (general) Service code 16 | 215 W SUPERIOR ST., STE 500 CHICAGO, IL 60654 | $33K |
| FIRST CHOICE HEALTH EIN 91-1272766 NONE | Claims processing Service code 12 | PO BOX 21367 BILLINGS, MT 59104 | $20K |
| RELIANCE STANDARD EIN 36-0883760 NONE | Insurance agents and brokers Service code 22 | 1700 MARKET STREET, SUITE 1200 PHILADELPHIA, PA 191033938 | $14K |
| DOUGLAS WILSON AND COMPANY P.C. EIN 81-0446334 NONE | Accounting (including auditing) Service code 10 | PO BOX 2845 GREAT FALLS, MT 59403 | $12K |
| TAKE CONTROL, INC. EIN 27-5492229 NONE | Consulting (general) Service code 16 | PO BOX 9132 MISSOULA, MT 59807 | $12K |
| MEDICAL REHABILITATION CONSULTANTS EIN 91-1448997 CONSULTING | Consulting (general) Service code 16 | 111 W CATALDO, SUITE 200 SPOKANE, WA 99201 | $9K |
| 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 | $7K |
| HEALTH RISK STRATEGIES, LLC EIN 41-1979502 NONE | Actuarial Service code 11 | 6804 BRITTANY ROAD EDINA, MN 55435 | $6K |
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 | 272 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 274 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL INSURANCE COMPANY | 187 | $73K |
| Vision | VISION SERVICE PLAN | 272 | $8K |
| Stop-loss / reinsurancereinsurance | BERKLEY ACCIDENT & HEALTH | 408 | $452K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 408 | — |
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."
No prospect flags tripped on this filing.