| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LEAVITT GROUP3 Filed as: LEAVITT GREAT WEST INSURANCE | 2345 KING AVE WEST, SUITE E BILLINGS, MT 59102 | BERKLEY LIFE AND HEALTH INSURANCE CO | $57K | $0 | $57K | 10.00% |
| LEAVITT GROUP3 Filed as: LEAVITT GREAT WEST INSURANCE | 2345 KING AVE WEST, SUITE E BILLINGS, MT 59102 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $2K | $8K | 19.62% |
| LEAVITT GROUP3 Filed as: LEAVITT GROUP INSURANCE ADVISORS | 560 S 300 E STE 150 SALT LAKE CITY, UT 84111 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $369 | $369 | 0.92% |
| LEAVITT GROUP3 Filed as: LEAVITT GREAT WEST INSURANCE | 2345 KING AVE WEST, SUITE E BILLINGS, MT 59102 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $516 | $186 | $702 | 13.61% |
| LEAVITT GROUP3 Filed as: LEAVITT GROUP INSURANCE ADVISORS | 560 S 300 E STE 150 SALT LAKE CITY, UT 84111 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $37 | $37 | 0.72% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPLOYEE BENEFIT MGMT SERVICES EIN 81-0391256 UTILIZATION REVIEW | Other fees; Contract Administrator Service code 13 | — | $85K |
| FIRST CHOICE EIN 91-1272766 PPO | Other services Service code 49 | — | $14K |
| SMITH RX EIN 81-1489804 RX ADMIN | Contract Administrator Service code 13 | — | $8K |
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. |
| Total participants (= "Plan participants" tile) | 194 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 223 | $5K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 50 | $40K |
| Stop-loss / reinsurancereinsurance | BERKLEY LIFE AND HEALTH INSURANCE CO | 194 | $573K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 223 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 223 | — |
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.