| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LEAVITT GROUP3 Filed as: LEAVITT GREAT WEST INSURANCE SERV | 3390 COLTON DR STE A HELENA, MT 59602 | AMERICAN FIDELITY ASSURANCE COMPANY | $39K | — | $39K | 10.00% |
| LEAVITT GROUP3 Filed as: LEAVITT GREAT WEST INSURANCE SERVIC | PO BOX 2518 BILLINGS, MT 59103 | DELTA DENTAL INSURANCE COMPANY | $8K | — | $8K | 10.00% |
| LEAVITT GROUP3 Filed as: LEAVITT GREAT WEST INSURANCE SVCS | 2345 KING AVE W STE E BILLINGS, MT 59102 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $432 | $4K | 13.81% |
| LEAVITT GROUP3 Filed as: LEAVITT GREAT WEST INS SERVICE | PO BOX 2518 BILLINGS, MT 59103 | VISION SERVICE PLAN | $1K | — | $1K | 5.07% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 731250360 | AMERICAN FIDELITY ASSURANCE COMPANY | $3K | — | $3K | 17.94% |
| LEAVITT GROUP3 Filed as: LEAVITT GREAT WEST INSURANCE SVCS | 2345 KING AVE W #E BILLINGS, MT 59102 | AMERICAN FIDELITY ASSURANCE COMPANY | $2K | — | $2K | 9.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPLOYEE BENEFIT MANAGEMENT SERVICE EIN 81-0391256 ADMINISTRATOR | Contract Administrator Service code 13 | — | $47K |
| FIRST CHOICE HEALTH EIN 91-1272766 PREFERRED PROVIDER ORG | Insurance services Service code 23 | — | $9K |
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 | 139 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 140 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL INSURANCE COMPANY | 128 | $84K |
| Vision | VISION SERVICE PLAN | 129 | $25K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,334 | $28K |
| Short-term disability | AMERICAN FIDELITY ASSURANCE COMPANY | 94 | $18K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,334 | $28K |
| Prescription drug | AMERICAN FIDELITY ASSURANCE COMPANY | 140 | $390K |
| Stop-loss / reinsurancereinsurance | AMERICAN FIDELITY ASSURANCE COMPANY | 140 | $390K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,334 | $46K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,334 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.