| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NIELSEN BENEFITS GROUP3 | 8899 S. 700 E. # 155 SANDY, UT 84070 | SELECT HEALTH | $50K | $17K | $67K | 4.00% |
| DAVIS PACIFIC BENEFITS3 | 5525 S. 900 E. # 100 SLC, UT 84117 | UNUM | $8K | — | $8K | 8.57% |
| DAVIS PACIFIC BENEFITS3 Filed as: DAVIS PACIFIC BENEFITS, LLC. | — | LIFE MAP ASSURANCE COMPANY | $2K | — | $2K | 15.01% |
| DPW BENEFITS LLC3 Filed as: DPW BENEFITS, LLC. | — | PRINCIPAL LIFE | $106 | — | $106 | 8.13% |
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 | 494 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 494 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | SELECT HEALTH | 494 | $1.7M |
| Dental | DENTAL MANAGEMENT ADMINISTRATORS | 463 | $9K |
| Life insurance(3 contracts, 3 carriers) | UNUM | 201 | $111K |
| Long-term disability | UNUM | 201 | $95K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 494 | — |
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.