| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | DENTAL MANAGEMENT ADMINISTRATORS | $5K | $0 | $5K | 9.17% |
| MORETON & COMPANY3 Filed as: FRED A MORETON & CO. | PO BOX 58139 SLC, UT 84158 | DENTAL MANAGEMENT ADMINISTRATORS | $856 | $0 | $856 | 1.67% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | TOTAL DENTAL ADMINISTRATORS OF UTAH | $595 | — | $595 | 5.63% |
| MORETON & COMPANY Filed as: FRED A MORETON & CO. | PO BOX 58139 SLC, UT 84158 | TOTAL DENTAL ADMINISTRATORS OF UTAH | $124 | $0 | $124 | 1.17% |
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 | 104 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 104 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | DENTAL MANAGEMENT ADMINISTRATORS | 180 | $62K |
| Stop-loss / reinsurancereinsurance | INTERNATIONAL ASSURANCE OF TN | 104 | $315K |
| Other | TOTAL DENTAL ADMINISTRATORS OF UTAH | 41 | $11K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 180 | — |
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.