| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GBS BENEFITS INC3 | 465 S 400 E STE 300 SALT LAKE CITY, UT 84111 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | $735 | $6K | 11.34% |
| GBS BENEFITS INC3 Filed as: GBS BENEFITS INC. | 465 S 400 E STE 300 SALT LAKE CITY, UT 84111 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $405 | $3K | 11.69% |
| GBS BENEFITS INC3 Filed as: GBS BENEFITS INC. | 465 S 400 E STE 300 SALT LAKE CITY, UT 84111 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $224 | $2K | 11.34% |
| GBS BENEFITS INC3 Filed as: GBS BENEFITS INC. | 465 S 400 E STE 300 SALT LAKE CITY, UT 84111 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $408 | $71 | $479 | 11.75% |
| GBS BENEFITS INS AGENCY3 Filed as: GBS INSURANCE AGENCY | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $2K | — | $2K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AMERICAN SPECIALTY HEALTH SERVICE PROVIDER | Float revenue; Named fiduciary; Claims processing; Contract Administrator; Direct payment from the plan; Non-monetary compensation; Other services; Participant communication Service code 12 | 10221 WATERIDGE CIRCLE STE 201 SAN DIEGO, CA 92121 | $27K |
| CIGNA HEALTH & LIFE INSURANCE COMPA | Float revenue; Claims processing; Copying and duplicating; Direct payment from the plan; Named fiduciary; Other services; Non-monetary compensation; Contract Administrator Service code 12 | — | $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 | 690 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 690 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 678 | $0 |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 678 | $24K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 690 | $55K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 678 | $17K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 678 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 690 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.