| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| G&G ASSOCIATES3 | 9176 SOUTH 300 WEST STE 10 SANDY, UT 84070 | SYMETRA | — | $25K | $25K | 2.82% |
| FINANCIAL CONSULTANTS OF AMERICA3 | 707 24TH STREET STE. B OGDEN, UT 84401 | DELTA DENTAL OF WYOMING | $10K | $0 | $10K | 5.01% |
| FLAMM RONALD3 | 295 EAST 3625 NORTH NORTH OGDEN, UT 84414 | HARTFORD LIFE AND ACCIDENT | $5K | $0 | $5K | 3.84% |
| FLAMM RICHARD3 | 1886 E 6200 S OGDEN, UT 84403 | HARTFORD LIFE AND ACCIDENT | $5K | $0 | $5K | 3.84% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC COMMSN | PO BOX 28852 NEW YORK, NY 10087 | AETNA LIFE INSURANCE CO. | $40 | $0 | $40 | 0.37% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| TOWERS WATSON OF PENNSYLVANIA BROKER | Claims processing Service code 12 | 71 SOUTH WACKER DRIVE CHICAGO, IL 60606 | $0 |
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 | 347 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 347 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF WYOMING | 242 | $192K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 270 | $141K |
| Other(2 contracts, 2 carriers) | SYMETRA | 304 | $889K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 304 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.