| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 | 1420 5TH AVENUE, SUITE 1500 SEATTLE, WA 98101 | DELTA DENTAL INSURANCE COMPANY | $13K | $0 | $13K | 10.00% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | PO BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $13K | $0 | $13K | 12.41% |
| LEAVITT GROUP3 Filed as: LEAVITT GREAT WEST INSURANCE | 2345 KING AVENUE W, SUITE E BILLINGS, MT 59102 | AMERICAN FIDELITY ASSURANCE COMPANY | $512 | $0 | $512 | 0.50% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1420 5TH AVENUE, SUITE 1500 SEATTLE, WA 98101 | AMERICAN FIDELITY ASSURANCE COMPANY | $458 | $0 | $458 | 0.45% |
| LEAVITT GROUP3 Filed as: LEAVITT GREAT WEST INSURANCE | 2345 KING AVENUE W, SUITE E BILLINGS, MT 59102 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $3K | $9K | 13.07% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1420 5TH AVENUE, SUITE 1500 SEATTLE, WA 98101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $255 | $4K | 5.25% |
| ALLIANT INSURANCE SERVICES, INC.3 | PO BOX 8299 PASADENA, CA 91109 | VISION SERVICE PLAN | $1K | $0 | $1K | 5.22% |
| LEAVITT GROUP3 Filed as: LEAVITT GREAT WEST INSURANCE | PO BOX 2518 BILLINGS, MT 59103 | VISION SERVICE PLAN | $3 | $0 | $3 | 0.01% |
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 | 209 | 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) | 209 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL INSURANCE COMPANY | 327 | $126K |
| Vision | VISION SERVICE PLAN | 143 | $23K |
| Life insurance(2 contracts, 2 carriers) | AMERICAN FIDELITY ASSURANCE COMPANY | 263 | $172K |
| Short-term disability | AMERICAN FIDELITY ASSURANCE COMPANY | 170 | $103K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 263 | $69K |
| Other(3 contracts, 3 carriers) | AMERICAN FIDELITY ASSURANCE COMPANY | 280 | $172K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 327 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.