| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LEAVITT GROUP3 Filed as: LEAVITT GREAT WEST INS SERVICES LLC | 3390 COLTON DR STE A HELENA, MT 59602 | LIFEMAP ASSURANCE COMPANY | $2K | — | $2K | 8.76% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ZENITH AMERICAN SOLUTIONS, INC. EIN 52-1590516 NONE | Direct payment from the plan; Claims processing; Accounting (including auditing); Recordkeeping and information management (computing, tabulating, data processing, etc.); Plan Administrator Service code 10 | — | $338K |
| MEDICAL REHABILITATION CONSULTANTS, EIN 91-1448997 NONE | Other services; Direct payment from the plan Service code 49 | — | $216K |
| INTERWEST HEALTH EIN 84-1375849 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $156K |
| CLEAR HEALTH STRATEGIES LLC NONE | Direct payment from the plan; Other services Service code 49 | 27299 RIVERVIEW CENTER BLVD BONITA SPRINGS, FL 34134 | $133K |
| REINHART BOERNER VAN DEUREN NORRIS EIN 39-1126909 NONE | Legal; Direct payment from the plan Service code 29 | — | $69K |
| LEAVITT GREAT WEST INS SERVICES LLC EIN 81-0520992 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $69K |
| ANASTASI, MOORE & MARTIN, PLLC EIN 20-8149084 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $51K |
| MEDIMPACT HEALTHCARE SYSTEMS, INC EIN 33-0567651 NONE | Other services; Claims processing; Direct payment from the plan Service code 12 | — | $36K |
| LAWTON PRINTING SERVICES NONE | Direct payment from the plan; Other services Service code 49 | 4111 E MISSION AVE SPOKANE, WA 99202 | $19K |
| WELLS FARGO EIN 94-1347393 NONE | Custodial (securities); Direct payment from the plan; Custodial (other than securities) Service code 18 | — | $13K |
| NICOLAI COCERGINE TRUSTEE | Direct payment from the plan; Trustee (individual) Service code 20 | P O BOX 567 BUTTE, MT 59703 | $8K |
| REDMOND GENERAL INSURANCE AGENCY NONE | Insurance services; Direct payment from the plan Service code 23 | 15809 BEAR CREEK PKWY #300 REDMOND, WA 98052 | $6K |
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 | 952 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 24 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 976 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 834 | $50K |
| Life insurance | LIFEMAP ASSURANCE COMPANY | 858 | $20K |
| Stop-loss / reinsurancereinsurance | TOKIO MARINE HCC | 1,309 | $434K |
| Other | LIFEMAP ASSURANCE COMPANY | 858 | $20K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,309 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.