| 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 BILLINTS, MT 59102 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $570 | $4K | 17.43% |
| 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 | — | $228 | $228 | 0.97% |
| LEAVITT GROUP3 Filed as: LEAVITT GREAT WEST INSURANCE SERVIC | PO BOX 2518 BILLINGS, MT 59103 | VISION SERVICE PLAN | $1K | — | $1K | 5.32% |
| 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 | $484 | $2K | 12.43% |
| 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 | $0 | $194 | $194 | 0.97% |
| 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 | $473 | $3K | 16.28% |
| 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 | $0 | $189 | $189 | 0.97% |
| 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 | $1K | $165 | $1K | 17.22% |
| 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 | $0 | $66 | $66 | 0.89% |
| 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 | $868 | $145 | $1K | 17.50% |
| 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 | $0 | $58 | $58 | 1.00% |
| 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 | $0 | $70 | $70 | 2.11% |
| 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 | $0 | $28 | $28 | 0.84% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BOON-CHAPMAN EIN 74-2305238 TPA | Contract Administrator Service code 13 | — | $59K |
| 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 | 178 | 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) | 178 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL INSURANCE COMPANY | 119 | $82K |
| Vision | VISION SERVICE PLAN | 102 | $22K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 178 | $20K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 23 | $7K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 178 | $19K |
| Stop-loss / reinsurancereinsurance(2 contracts) | BERKLEY LIFE AND HEALTH INSURANCE COMPANY | 145 | $426K |
| Other(4 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 178 | $52K |
| 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.