| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LEAVITT GROUP3 Filed as: LEAVITT GREAT WEST INS/MARY PUCKETT | 3390 COLTON DR STE A HELENA, MT 59602 | ALLEGIANCE LIFE & HEALTH INSURANCE COMPANY | $43K | — | $43K | 2.04% |
| LEAVITT GROUP3 Filed as: LEAVITT GREAT WEST INS SERVICE | 2345 KING AVENUE WEST SUITE A BILLINGS, MT 59103 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 3.15% |
| LEAVITT GROUP3 Filed as: LEAVITT GREAT WEST INSURANCE SERVIC | 3390 COLTON DRIVE, STE A HELENA, MT 59602 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | — | $10K | 13.12% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNEWEST INSURANCE INC | 2925 PALMER ST STE B MISSOULA, MT 59808 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $29 | — | $29 | 0.04% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNEWEST INSURANCE INC | 2925 PALMER ST STE B MISSOULA, MT 59808 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $795 | — | $795 | 3.46% |
| LEAVITT GROUP3 Filed as: LEAVITT GREAT WEST INSURANCE S | 3390 COLTON DRIVE STE A HELENA, MT 59602 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $763 | — | $763 | 9.88% |
No Schedule C service providers reported on this filing.
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 | 349 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 349 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ALLEGIANCE LIFE & HEALTH INSURANCE COMPANY | 632 | $2.1M |
| Dental(2 contracts, 2 carriers) | ALLEGIANCE LIFE & HEALTH INSURANCE COMPANY | 632 | $2.3M |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 243 | $216K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 344 | $83K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 91 | $23K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 344 | $75K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 632 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.