| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LEAVITT GROUP3 Filed as: LEAVITT GREAT WEST INS SERVICES LLC | 2345 KING AVENUE WEST, SUITE A BILLINGS, MT 59103 | LIFEMAP ASSURANCE COMPANY | $2K | — | $2K | 6.17% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ZENITH AMERICAN SOLUTIONS, INC. EIN 52-1590516 NONE | Accounting (including auditing); Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Plan Administrator; Direct payment from the plan Service code 10 | — | $331K |
| MEDICAL REHABILITATION CONSULTANTS EIN 91-1448997 NONE | Direct payment from the plan; Other services Service code 49 | — | $243K |
| MEDIMPACT HEALTHCARE SYSTEMS, INC. EIN 33-0567651 NONE | Claims processing; Direct payment from the plan; Other services Service code 12 | — | $77K |
| FIRST CHOICE HEALTH NETWORK NONE | Other services; Direct payment from the plan Service code 49 | 120 WEST CATALDO AVENUE, SUITE 200 SPOKANE, WA 99201 | $71K |
| REINHART BOERNER VAN DEUREN S.C. EIN 41-2981000 NONE | Legal Service code 29 | — | $70K |
| LEAVITT GREAT WEST INS SERVICES LLC EIN 81-0520992 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $70K |
| SEGAL NONE | Consulting (general); Direct payment from the plan Service code 16 | 333 WEST 34TH ST NEW YORK, NY 10001 | $58K |
| CLEARHEALTH STRATEGIES NONE | Direct payment from the plan; Other services Service code 49 | 27299 RIVERVIEW CENTER BLVD BONITA SPRINGS, FL 34134 | $28K |
| MULTIPLAN, INC. NONE | Direct payment from the plan; Other services Service code 49 | 115 5TH AVENUE NEW YORK, NY 10003 | $23K |
| INTERWEST HEALTH EIN 84-1375849 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $22K |
| ANASTASI, MOORE & MARTIN, PLLC EIN 20-8149084 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $18K |
| LAWTON PRINTING SERVICES NONE | Direct payment from the plan; Other services Service code 49 | 4111 E MISSION AVENUE SPOKANE, WA 99202 | $17K |
| WELLS FARGO BANK, N.A EIN 94-1347393 NONE | Direct payment from the plan; Custodial (other than securities); Trustee (bank, trust company, or similar financial institution); Custodial (securities) Service code 18 | — | $15K |
| DENISE SACRY TRUSTEE | Direct payment from the plan; Other services Service code 49 | P.O. BOX 567 BUTTE, MT 59703 | $12K |
| REDMOND GENERAL INSURANCE AGENCY NONE | Direct payment from the plan; Insurance services Service code 23 | 15809 BEAR CREEK PARKWAY, STE 300 REDMOND, WA 98052 | $6K |
| LEGEND DATA SYSTEMS, INC. NONE | Direct payment from the plan; Other services Service code 49 | 18024 72ND AVENUE SOUTH KENT, WA 98032 | $6K |
| TERRIE TRETTENBACH TRUSTEE | Direct payment from the plan; Other services Service code 49 | 2531 HUMMINGBIRD WAY BILLINGS, MT 59105 | $6K |
| HILDI INC. NONE | Direct payment from the plan; Actuarial Service code 11 | 14852 SCENIC HEIGHTS RD, SUITE 205 EDEN PRAIRIE, MN 55344 | $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 | 1,007 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 20 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,027 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 862 | $54K |
| Life insurance | LIFEMAP ASSURANCE COMPANY | 964 | $31K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | HCC LIFE INSURANCE COMPANY | 1,314 | $630K |
| Other | LIFEMAP ASSURANCE COMPANY | 964 | $31K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,314 | — |
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.