| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GBS BENEFITS INS AGENCY3 | 465 S 400 E #300 SALT LAKE CITY, UT 84111 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $1K | $1K | 0.30% |
| GBS BENEFITS INC3 Filed as: GBS BENEFITS | 465 S 400 E #300 SALT LAKE CITY, UT 84111 | THE LINCOLN NATIONAL LIFE INS COMPANY | $4K | $1K | $5K | 19.06% |
| GBS BENEFITS INS AGENCY3 | 465 S 400 E #300 SALT LAKE CITY, UT 84111 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | $931 | $4K | 18.27% |
| GBS BENEFITS INC3 Filed as: GBS BENEFITS | 465 S 400 E #300 SALT LAKE CITY, UT 84111 | THE LINCOLN NATIONAL LIFE INS COMPANY | $2K | $366 | $2K | 11.88% |
| GBS BENEFITS INS AGENCY3 | 465 S 400 E #300 SALT LAKE CITY, UT 84111 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $715 | $258 | $973 | 17.68% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH & LIFE INS COMPANY EIN 59-1031071 CARRIER | Float revenue; Participant communication; Other services; Non-monetary compensation; Direct payment from the plan; Claims processing; Named fiduciary; Contract Administrator Service code 12 | — | $20K |
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 | 149 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 149 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 149 | $414K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 149 | $414K |
| Vision | THE LINCOLN NATIONAL LIFE INS COMPANY | 96 | $19K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 142 | $6K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 140 | $20K |
| Other(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INS COMPANY | 142 | $31K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 149 | — |
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."
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.