| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DAVIS PACIFIC BENEFITS3 Filed as: DAVIS PACIFIC BENEFITS LLC | 5525 900 E, SUITE 100 SALT LAKE CITY, UT 84117 | REGENCE BLUECROSS BLUESHIELD OF UTAH | $51K | $31K | $82K | 1.16% |
| DAVIS PACIFIC BENEFITS3 Filed as: DAVIS PACIFIC BENEFITS, LLC | 5525 S 900 E SUITE 100 SALT LAKE CITY, UT 84117 | METROPOLITAN LIFE INSURANCE COMPANY | $25K | — | $25K | 10.80% |
| DAVIS PACIFIC BENEFITS3 Filed as: DAVIS PACIFIC BENEFITS LLC | 4001 S 700 E SUITE 40 SALT LAKE CITY, UT 84107 | SUN LIFE ASSURANCE COMPANY OF CANADA | $4K | — | $4K | 6.66% |
| UNITED BENEFIT ADVISORS LLC3 | 1 PIERCE PLACE SUITE 400E ITASCA, IL 60143 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $624 | $624 | 0.97% |
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 | 705 | 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) | 705 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | REGENCE BLUECROSS BLUESHIELD OF UTAH | 702 | $7.0M |
| Vision | REGENCE BLUECROSS BLUESHIELD OF UTAH | 702 | $7.0M |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 2,097 | $236K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 709 | $65K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 2,097 | $236K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,097 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.