| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 6967 SOUTH RIVER GATE DRIVE SUITE 200 MIDVALE, UT 84047 | SELECTHEALTH | $37K | $17K | $54K | 2.98% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 6330 SOUTH 3000 EAST, SUITE 670 SALT LAKE CITY, UT 84121 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $75 | $4K | 2.72% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $2K | $2K | 1.69% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 100 MATSONFORD ROAD FOUR RADNOR CORP. CENTER, SUITE 510 RADNOR, PA 19087 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $15 | $15 | 0.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $6K | $0 | $6K | 12.64% |
| TIMOTHY B. CRAIG3 | 11829 SOUTH PINNACLE ACRE COURT RIVERTON, UT 84065 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | $0 | $2K | 12.55% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 6967 SOUTH RIVER GATE DRIVE SUITE 200 MIDVALE, UT 84047 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | $0 | $1K | 9.68% |
| CLINT WEIGHT3 | 745 SOUTH 180 WEST SALEM, UT 84653 | CONTINENTAL AMERICAN INSURANCE COMPANY | $27 | $0 | $27 | 0.20% |
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 | 134 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 134 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | SELECTHEALTH | 1,080 | $1.8M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 725 | $141K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 134 | $50K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 134 | $50K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 134 | $50K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 134 | $50K |
| Prescription drug | SELECTHEALTH | 1,080 | $1.8M |
| Other(3 contracts, 3 carriers) | SELECTHEALTH | 1,080 | $1.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,080 | — |
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.