| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| IMA, INC.3 | 95 SOUTH STATE STREET, SUITE 1300 SALT LAKE CITY, UT 84111 | AMERITAS LIFE INSURANCE CORP | $24K | $0 | $24K | 10.00% |
| IMA, INC.3 | 1705 17TH STREET, SUITE 100 DENVER, CO 80202 | AMERITAS LIFE INSURANCE CORP | $0 | $11K | $11K | 4.49% |
| IMA, INC.3 | 95 SOUTH STATE STREET, SUITE 1300 SALT LAKE CITY, UT 84111 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $10K | $0 | $10K | 18.92% |
| ASSUREX3 | 175 SOUTH 3RD STREET, SUITE 800 COLUMBUS, OH 43215 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $2K | $2K | 3.79% |
| IMA, INC.3 | 95 SOUTH STATE STREET, SUITE 1300 SALT LAKE CITY, UT 84111 | PRE-PAID LEGAL SERVICES INC DBA LEGAL SHIELD | $7K | $0 | $7K | 14.96% |
| D'ANN DABELL4 Filed as: D ANN DABELL | 1174 NORTH 2000 EAST LAYTON, UT 84040 | PRE-PAID LEGAL SERVICES INC DBA LEGAL SHIELD | $4K | $0 | $4K | 9.03% |
| SHALANDA ZAKIA FLETCHER SMITH4 | PO BOX 440432 KENNESAW, GA 30160 | PRE-PAID LEGAL SERVICES INC DBA LEGAL SHIELD | $21 | $0 | $21 | 0.05% |
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 | 1,332 | 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) | 1,332 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | AMERITAS LIFE INSURANCE CORP | 2,679 | $243K |
| Life insurance | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,332 | $995K |
| Short-term disability | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,332 | $995K |
| Long-term disability(2 contracts, 2 carriers) | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,332 | $1.0M |
| Other(2 contracts, 2 carriers) | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,332 | $1.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,679 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.