| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LEAVITT GROUP3 Filed as: LEAVITT GREAT WEST INSURANCE | 2345 KING AVE WEST, SUITE E BILLINGS, MT 59102 | DELTA DENTAL INSURANCE COMPANY | $9K | $0 | $9K | 10.00% |
| LEAVITT GROUP3 Filed as: LEAVITT GREAT WEST INSURANCE | 2345 KING AVE WEST, SUITE E BILLINGS, MT 59102 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $1K | $5K | 20.45% |
| LEAVITT GROUP3 Filed as: LEAVITT GREAT WEST INSURANCE | 2345 KING AVE WEST, SUITE E BILLINGS, MT 59102 | VISION SERVICE PLAN | $1K | $0 | $1K | 5.42% |
| LEAVITT GROUP3 Filed as: LEAVITT GREAT WEST INSURANCE | 2345 KING AVE WEST, SUITE E BILLINGS, MT 59102 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $1K | $3K | 15.81% |
| LEAVITT GROUP3 Filed as: LEAVITT GREAT WEST INSURANCE | 2345 KING AVE WEST, SUITE E BILLINGS, MT 59102 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 19.86% |
| LEAVITT GROUP3 Filed as: LEAVITT GREAT WEST INSURANCE | 2345 KING AVE WEST, SUITE E BILLINGS, MT 59102 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $428 | $2K | 20.22% |
| LEAVITT GROUP3 Filed as: LEAVITT GREAT WEST INSURANCE | 2345 KING AVE WEST, SUITE E BILLINGS, MT 59102 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $785 | $295 | $1K | 20.63% |
| LEAVITT GROUP3 Filed as: LEAVITT GREAT WEST INSURANCE | 2345 KING AVE WEST, SUITE E BILLINGS, MT 59102 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $305 | $305 | 9.14% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPLOYEE BENEFIT MGMT SYSTEMS LLC EIN 81-0391256 TPA | Contract Administrator Service code 13 | — | $50K |
| FIRST CHOICE HEALTH EIN 91-1272766 PPO | Other services Service code 49 | — | $10K |
| NAVITUS HEALTH SOLUTIONS EIN 04-3608530 PBM | Claims processing Service code 12 | — | $9K |
| IT STARTS WITH ME EIN 20-1378738 HEALTH SCREENING | Other fees Service code 99 | — | $9K |
| AMERICAN HEALTH HOLDING, INC. EIN 31-1368946 PHYSICIAN CONSULTING | Other fees Service code 99 | — | $5K |
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 | 153 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 155 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL INSURANCE COMPANY | 244 | $94K |
| Vision | VISION SERVICE PLAN | 106 | $21K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 206 | $20K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 24 | $8K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 206 | $18K |
| Stop-loss / reinsurancereinsurance | BERKLEY ACCIDENT & HEALTH | 302 | $365K |
| Other(4 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 206 | $52K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 302 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.