| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JASON WAGNER3 | 2200 S MAIN ST STE #600 SOUTH SALT LAKE, UT 84115 | MOTIVHEALTH INSURANCE CO. | $73K | — | $73K | 2.99% |
| GBS BENEFITS INC3 | 2200 S MAIN ST STE 600 SOUTH SALT LAKE, UT 84115 | UNITEDHEALTHCARE INSURANCE COMPANY | $21K | $59 | $21K | 9.97% |
| GBS BENEFITS INC3 | 465 S 400 E STE 300 SALT LAKE CITY, UT 84111 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $12K | $3K | $16K | 16.24% |
| LEAVITT GROUP3 Filed as: LEAVITT GREAT WEST INS SERVICES LLC | 2345 KING AVE W STE E BILLINGS, MT 59102 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $442 | $442 | 0.46% |
| EMPLOYEE CHOICE SOLUTIONS3 Filed as: EMPLOYEE CHOICE SOLUTION | 2200 S MAIN STREET STE 600 SALT LAKE CITY, UT 84115 | GUARDIAN | $11K | $1K | $12K | 19.96% |
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 | 258 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 258 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 577 | $214K |
| Dental | GUARDIAN | 105 | $58K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 300 | $96K |
| Short-term disability | GUARDIAN | 105 | $58K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 300 | $96K |
| Prescription drug | MOTIVHEALTH INSURANCE CO. | 681 | $2.5M |
| Stop-loss / reinsurancereinsurance | MOTIVHEALTH INSURANCE CO. | 681 | $2.5M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 300 | $96K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 681 | — |
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.