| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LEAVITT GROUP3 Filed as: LEAVITT GREAT WEST INS SVCS | — | DELTA DENTAL INSURANCE COMPANY | $8K | — | $8K | 10.00% |
| LEAVITT GROUP3 Filed as: LEAVITT GREAT WEST INS SERVICES LLC | 2345 KING AVENUE WEST SUITE E BILLINGS, MT 59102 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $5K | 20.05% |
| LEAVITT GROUP3 Filed as: LEAVITT GROUP INSUR ADVISORS INC | 560 SOUTH 300 EAST SUITE 150 SALT LAKE CITY, UT 84111 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $227 | $227 | 1.01% |
| LEAVITT GROUP3 Filed as: LEAVITT GREAT WEST INSURANCE SERVIC | PO BOX 2518 BILLINGS, MT 59103 | VISION SERVICE PLAN | $1K | — | $1K | 5.42% |
| LEAVITT GROUP3 Filed as: LEAVITT GREAT WEST INS SERVICES LLC | 2345 KING AVENUE WEST SUITE E BILLINGS, MT 59102 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $938 | $3K | 14.93% |
| LEAVITT GROUP3 Filed as: LEAVITT GROUP INSUR ADVISORS INC | 560 SOUTH 300 EAST SUITE 150 SALT LAKE CITY, UT 84111 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $188 | $188 | 0.99% |
| LEAVITT GROUP3 Filed as: LEAVITT GREAT WEST INS SERVICES LLC | 2345 KING AVENUE WEST SUITE E BILLINGS, MT 59102 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $884 | $3K | 18.89% |
| LEAVITT GROUP3 Filed as: LEAVITT GROUP INSUR ADVISORS INC | 560 SOUTH 300 EAST SUITE 150 SALT LAKE CITY, UT 84111 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $177 | $177 | 0.96% |
| LEAVITT GROUP3 Filed as: LEAVITT GREAT WEST INS SERVICES LLC | 2345 KING AVENUE WEST SUITE E BILLINGS, MT 59102 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $914 | $331 | $1K | 20.43% |
| LEAVITT GROUP3 Filed as: LEAVITT GROUP INSUR ADVISORS INC | 560 SOUTH 300 EAST SUITE 150 SALT LAKE CITY, UT 84111 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $66 | $66 | 1.08% |
| LEAVITT GROUP3 Filed as: LEAVITT GREAT WEST INS SERVICES LLC | 2345 KING AVENUE WEST SUITE E BILLINGS, MT 59102 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $880 | $300 | $1K | 20.12% |
| LEAVITT GROUP3 Filed as: LEAVITT GROUP INSUR ADVISORS INC | 560 SOUTH 300 EAST SUITE 150 SALT LAKE CITY, UT 84111 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $60 | $60 | 1.02% |
| LEAVITT GROUP3 Filed as: LEAVITT GREAT WEST INS SERVICES LLC | 2345 KING AVENUE WEST SUITE E BILLINGS, MT 59102 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $117 | $117 | 5.13% |
| LEAVITT GROUP3 Filed as: LEAVITT GROUP INSUR ADVISORS INC | 560 SOUTH 300 EAST SUITE 150 SALT LAKE CITY, UT 84111 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $23 | $23 | 1.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BOON-CHAPMAN EIN 74-2305238 TPA | Contract Administrator Service code 13 | — | $53K |
| BOON CHAPMAN, LTD EIN 75-1501015 TPA | Claims processing Service code 12 | — | $14K |
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 | 194 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 196 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL INSURANCE COMPANY | 110 | $78K |
| Vision | VISION SERVICE PLAN | 103 | $21K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 178 | $19K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 18 | $6K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 178 | $18K |
| Stop-loss / reinsurancereinsurance | BERKLEY LIFE AND HEALTH INSURANCE COMPANY | 136 | $298K |
| Other(4 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 178 | $50K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 178 | — |
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.