| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PCF INSURANCE SERVICES OF THE WEST3 Filed as: PCF INSURNACE SERVICES OF THE WEST | DBA BUIE INS 4525 S 2300 E STE 201 HOLLADAY, UT 84117 | PRINCIPAL LIFE INSURANCE COMPANY | $16K | — | $16K | 6.75% |
| PARAGON PARTNERS LTD3 | STE C-103 9420 E DOUBLETREE RANCH RD SCOTTSDALE, AZ 85258 | PRINCIPAL LIFE INSURANCE COMPANY | — | $12K | $12K | 4.99% |
| PCF INSURANCE SERVICES OF THE WEST3 Filed as: NATIONAL PCF BONUS ONLY | 2500 W EXECUTIVE PKWY STE 200 LEHI, UT 84043 | PRINCIPAL LIFE INSURANCE COMPANY | — | $4K | $4K | 1.66% |
| PCF INSURANCE SERVICES OF THE WEST3 Filed as: PCF INS SERVICES OF THE WEST LLC | DBA RBI BENEFITS INSURANCE 90 W 500 S PMB 243 BOUNTIFUL, UT 84010 | PRINCIPAL LIFE INSURANCE COMPANY | — | $3K | $3K | 1.40% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| NATIONAL HEATH INSURANCE COMPANY EIN 74-1541799 CLAIM PROCESSOR | Claims processing Service code 12 | — | $159K |
| MILLER & ASSOCIATES INSURANCE BROKER | Claims processing Service code 12 | 574 N 1510 W LINDON, UT 84042 | $57K |
| NATIONAL GENERAL INSURANCE COMPANY EIN 43-0890050 CLAIM PROCESSOR | Claims processing Service code 12 | — | $39K |
| PARAGON PARTNERS LTD BROKER | Claims processing Service code 12 | 9420 E DOUBLE TREE RANCH RD STE C103 SCOTTDALE, AZ 85258 | $8K |
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 | 158 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 158 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | NATIONAL HEALTH INSURANCE COMPANY | 116 | $1.5M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 439 | $244K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 439 | $244K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 439 | $244K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 439 | $244K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 439 | $244K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 439 | — |
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.