| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LEAVITT GROUP3 Filed as: LEAVITT GREAT WEST INSURANCE | 2345 KING AVE WEST, SUITE B BILLINGS, MT 59102 | EBMS RE-BENCHMARK INSURANCE CO | $56K | — | $56K | 11.00% |
| EMPLOYEE BENEFIT MGMT SERVICES LLC5 Filed as: EMPLOYEE BENEFIT MGMT SERVICES INC | 2075 OVERLAND AVE BILLINGS, MT 59102 | EBMS RE-BENCHMARK INSURANCE CO | $10K | — | $10K | 2.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPLOYEE BENEFIT MGMT SERVICES, INC EIN 81-0391256 TPA ADMIN | Contract Administrator Service code 13 | — | $119K |
| AETNA SIGNATURE ADMINISTRATORS EIN 06-6033492 PPO | Other services Service code 49 | — | $35K |
| EMPLOYEE BENEFIT MGMT SERVICES INC EIN 81-0391256 UTILIZATION REVIEW | Other fees Service code 99 | — | $16K |
| MEDIMPACT HEALTHCARE SYSTEMS EIN 33-0567651 PBM | Claims processing Service code 12 | — | $11K |
| FIRST CHOICE HEALTH EIN 91-1272766 PPO | Other services Service code 49 | — | $10K |
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 | 356 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 359 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EBMS RE-BENCHMARK INSURANCE CO | 835 | $513K |
| Prescription drug | EBMS RE-BENCHMARK INSURANCE CO | 835 | $513K |
| Stop-loss / reinsurancereinsurance | EBMS RE-BENCHMARK INSURANCE CO | 835 | $513K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 835 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.