| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DANIEL D NELSON3 Filed as: DANIEL NELSON FINANCIAL GROUP INC | 8753 E BELL RD STE 110 SCOTTSDALE, AZ 85260 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $144K | $2K | $146K | 5.94% |
| ADVANTAGE INSURANCE SERVICES, INC.3 Filed as: ADVANTAGE INSURANCE SERVICES INC | 1580 MAKALOA STREET SUITE 1220 HONOLULU, HI 96814 | UNIVERSITY HEALTH ALLIANCE | $14K | $0 | $14K | 5.54% |
| DANIEL DAVID NELSON3 | 8753 E BELL RD STE 110 SCOTTSDALE, AZ 85260 | DELTA DENTAL INSURANCE COMPANY | $8K | $0 | $8K | 5.00% |
| DANIEL D NELSON3 | 8753 E BELL RD STE 110 SCOTTSDALE, AZ 85260 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $9K | $0 | $9K | 10.00% |
| DANIEL D NELSON3 | 8753 E BELL RD STE 110 SCOTTSDALE, AZ 85260 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | $0 | $10K | 19.85% |
| DANIEL D NELSON3 | 8753 E BELL RD STE 110 SCOTTSDALE, AZ 85260 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | $0 | $5K | 10.00% |
| DANIEL D NELSON3 | 8753 E BELL RD STE 110 SCOTTSDALE, AZ 85260 | VISION SERVICE PLAN | $2K | $0 | $2K | 4.09% |
| SHANNON L BRITTENHAM3 | 134 W BOWMAN DR KALISPELL, MT 59901 | CONTINENTAL AMERICAN INSURANCE COMPANY | $5K | $0 | $5K | 15.55% |
| CRAIG MICHELSEN3 Filed as: CRAIG S MICHELSEN | 914 20TH STREET SOUTH GREAT FALLS, MT 59405 | CONTINENTAL AMERICAN INSURANCE COMPANY | $479 | $0 | $479 | 1.65% |
| JODY L WALK3 | 2445 LAKE VISTA CT 115 CASSELBERRY, FL 32707 | CONTINENTAL AMERICAN INSURANCE COMPANY | $397 | $0 | $397 | 1.37% |
| WOITH INSURANCE AGENCY INC3 | 1725 41ST STREET S GREAT FALLS, MT 59405 | CONTINENTAL AMERICAN INSURANCE COMPANY | $174 | $0 | $174 | 0.60% |
| LISA M HALL3 | 6 EAGLE VIEW DRIVE CLANCY, MT 59634 | CONTINENTAL AMERICAN INSURANCE COMPANY | $103 | $0 | $103 | 0.35% |
| ANDREW G THEIS3 | 2048 OVERLAND AVE 202 BILLINGS, MT 59102 | CONTINENTAL AMERICAN INSURANCE COMPANY | $55 | $0 | $55 | 0.19% |
| JAMES A PORTER3 | 223 STILLWATER CREEK DR BOXEMAN, MT 59718 | CONTINENTAL AMERICAN INSURANCE COMPANY | $22 | $0 | $22 | 0.08% |
| DAWN D SHEUE3 Filed as: DAWN SHUE | PO BOX 3986 JACKSON, WY 83001 | CONTINENTAL AMERICAN INSURANCE COMPANY | $16 | $0 | $16 | 0.06% |
| CASEY D HOBSON3 | 815 S BRIDGEWAY PLACE STE 100 EAGLE, ID 83616 | CONTINENTAL AMERICAN INSURANCE COMPANY | $11 | $0 | $11 | 0.04% |
| ALESSANDRA L GEORGE3 | 736 COLUMBIA AVE WHITEFISH, MT 59937 | CONTINENTAL AMERICAN INSURANCE COMPANY | $10 | $0 | $10 | 0.03% |
| DANIEL D NELSON3 | 8753 E BELL RD STE 110 SCOTTSDALE, AZ 85260 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $0 | $3K | 10.00% |
| DANIEL D NELSON3 | 8753 E BELL RD STE 110 SCOTTSDALE, AZ 85260 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $0 | $1K | 11.00% |
| DANIEL D NELSON3 | 8753 E BELL RD STE 110 SCOTTSDALE, AZ 85260 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $275 | $0 | $275 | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 ADMINISTRATION | Named fiduciary; Direct payment from the plan; Non-monetary compensation; Contract Administrator; Participant communication; Other services; Float revenue; Claims processing Service code 12 | — | $6K |
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 | 337 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 341 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 538 | $2.7M |
| Dental(2 contracts, 2 carriers) | UNIVERSITY HEALTH ALLIANCE | 383 | $407K |
| Vision(2 contracts, 2 carriers) | UNIVERSITY HEALTH ALLIANCE | 223 | $287K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 426 | $87K |
| Short-term disability(3 contracts, 2 carriers) | CONTINENTAL AMERICAN INSURANCE COMPANY | 95 | $70K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 75 | $48K |
| Prescription drug(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 538 | $2.7M |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 374 | $83K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 538 | — |
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.