| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNE WEST INSURANCE INC | PO BOX 30638 BILLINGS, MT 59107 | DELTA DENTAL INSURANCE COMPANY | $7K | — | $7K | 9.15% |
| LEAVITT GROUP3 Filed as: LEAVITT GREAT WEST INS SVCS | 2345 KING AVE W STE B BILLINGS, MT 59102 | DELTA DENTAL INSURANCE COMPANY | $683 | — | $683 | 0.85% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNE WEST INSURANCE INC | 2925 PALMER ST SUITE B MISSOULA, MT 59806 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $751 | $6K | 12.71% |
| LEAVITT GROUP3 Filed as: LEAVITT GREAT WEST INSURANCE SVCS | 2345 KING AVE WEST BILLINGS, MT 59102 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $450 | $28 | $478 | 0.94% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNE WEST INSURANCE INC | 2925 PALMER ST SUITE B MISSOULA, MT 59806 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $305 | $3K | 15.23% |
| LEAVITT GROUP3 Filed as: LEAVITT GREAT WEST INSURANCE SVCS | 2345 KING AVE WEST BILLINGS, MT 59102 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $256 | $13 | $269 | 1.29% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNEWEST INSURANCE INC | PO BOX 30638 BILLINGS, MT 59107 | VISION SERVICE PLAN | $943 | — | $943 | 5.61% |
| LEAVITT GROUP3 Filed as: LEAVITT GREAT WEST INSURANCE SVCS | PO BOX 2518 BILLINGS, MT 59107 | VISION SERVICE PLAN | $49 | — | $49 | 0.29% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNE WEST INSURANCE INC | 2925 PALMER ST SUITE B MISSOULA, MT 59806 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $216 | $2K | 17.04% |
| AON CONSULTING INC3 Filed as: BSWIFT | STE 1100 10 S RIVERSIDE PLAZA CHICAGO, IL 60606 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $360 | — | $360 | 3.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PAYNE WEST INSURANCE INC | 2925 PALMER ST SUITE B MISSOULA, MT 59806 | UNUM LIFE INSURNACE COMPANY OF AMERICA | $943 | $96 | $1K | 16.15% |
| LEAVITT GROUP3 Filed as: LEAVITT GREAT WEST INSURNACE SVCS | 2345 KING AVE WEST BILLINGS, MT 59102 | UNUM LIFE INSURNACE COMPANY OF AMERICA | $86 | $4 | $90 | 1.40% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPLOYEE BENEFIT MGMT SERVICES EIN 81-0391256 ADMIN FEES | Contract Administrator Service code 13 | — | $40K |
| FIRST CHOICE HEALTH EIN 91-1272766 PPO | Other services Service code 49 | — | $8K |
| NAVITUS HEALTH SOLUTIONS EIN 04-3608530 PBM | Claims processing Service code 12 | — | $7K |
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 | 155 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 155 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL INSURANCE COMPANY | 254 | $81K |
| Vision | VISION SERVICE PLAN | 86 | $17K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 210 | $51K |
| Short-term disability | UNUM LIFE INSURNACE COMPANY OF AMERICA | 22 | $6K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 210 | $51K |
| Stop-loss / reinsurancereinsurance | BENCHMARK INSURANCE CO | 304 | $368K |
| Other(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 210 | $84K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 304 | — |
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.