| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MIKE DERU3 | 393 WEST GORDON AVE. SUITE 1 LAYTON, UT 84041 | HSA HEALTH INSURANCE CO. | $20K | $0 | $20K | 2.97% |
| JEANA HUTCHINGS3 | 136 E SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 84111 | HSA HEALTH INSURANCE CO. | $13K | $0 | $13K | 2.00% |
| DIVERSIFIED INSURANCE GROUP3 | 136 E SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 84111 | ACE AMERICAN INSURANCE COMPANY | $6K | $0 | $6K | 10.57% |
| FRINGE BENEFIT ANALYSTS LLC3 | 393 W GORDON AVE STE 1 LAYTON, UT 84041 | GUARDIAN | $617 | $0 | $617 | 9.10% |
| DIVERSIFIED INSURANCE GROUP3 | 136 E SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 84111 | GUARDIAN | $399 | $0 | $399 | 5.89% |
| RYAN H BECK3 | 756 E WINCHESTER BLVD MURRY, UT 84107 | GUARDIAN | $23 | $0 | $23 | 0.34% |
No Schedule C service providers reported on this filing.
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 | 408 | 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) | 408 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HSA HEALTH INSURANCE CO. | 408 | $736K |
| Dental | ACE AMERICAN INSURANCE COMPANY | 97 | $53K |
| Prescription drug | HSA HEALTH INSURANCE CO. | 408 | $657K |
| Other | GUARDIAN | 51 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 408 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.