| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MOUNTAIN WEST BENEFIT SOLUTIONS3 | 3390 COLTON DR STE A HELENA, MT 59602 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | $432 | $9K | 15.75% |
| MONTANA AUTOMOBILE DEALERS ASSOC0 | 501 N. SANDERS STREET HELENA, MT 59601 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 10.84% |
| LEAVITT GROUP3 Filed as: LEAVITT GREAT WEST INSURANCE SERVIC | 2345 KING AVE WEST SUITE A BILLINGS, MT 59103 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $844 | — | $844 | 5.33% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPLOYEE BENEFIT MANAGEMENT SERVICE EIN 81-0391256 THIRD PARTY ADMIN | Contract Administrator Service code 13 | — | $215K |
| EMPLOYEE BENEFIT MGMT SERVICES EIN 81-1391256 WELLNESS | Insurance services; Other fees Service code 23 | — | $44K |
| MOUNTAIN WEST BENEFIT SOLUTIONS EIN 26-0576978 CONSULTING | Consulting (general); Insurance services Service code 16 | — | $39K |
| INTERWEST HEALTH EIN 84-1375849 PPO | Other services Service code 49 | — | $29K |
| MEDIMPACT EIN 33-0567651 RX ADMIN FEES | Claims processing Service code 12 | — | $25K |
| DEPARTMENT OF THE TREASURY TAXING AUTHORITY | Other fees Service code 99 | INTERNAL REVENUE SERVICE CINCINNATI, OH 459990009 | $17K |
| JCCS, PC EIN 81-0348775 AUDITOR | Accounting (including auditing) Service code 10 | — | $13K |
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 | 992 | 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) | 992 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 827 | $24K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 804 | $58K |
| Prescription drug | COMPANION LIFE INSURANCE COMPANY | 1,274 | $510K |
| Stop-loss / reinsurancereinsurance | COMPANION LIFE INSURANCE COMPANY | 1,274 | $510K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 804 | $73K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,274 | — |
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.