| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DESERET INSURANCE AGENCY 4933 Filed as: DESERET INSURANCE AGENCY | 390 S MAIN ST BOUNTIFUL, UT 84010 | SELECT HEALTH | $5K | $0 | $5K | 0.41% |
| NIELSON INSURANCE GROUP INC.3 Filed as: NIELSON INSURANCE GROUP | 10542 S JORDAN GATEWAY SOUTH JORDAN, UT 84095 | SELECT HEALTH | $3K | $0 | $3K | 0.23% |
| DESERET INSURANCE AGENCY 4933 | 390 SOUTH MAIN ST BOUNTIFUL, UT 84010 | DENATL MANAGEMENT ADMINISTRATORS | $4K | $0 | $4K | 3.95% |
| GIBBS CALVIN3 | 757 W 700 S WOODS CROSS, UT 84087 | THE HARTFORD | $5K | $0 | $5K | 7.89% |
| HAWKINS CHARLES3 | 4505 SOUTH WASATCH BLVD STE 110 SALT LAKE CITY, UT 84124 | THE HARTFORD | $4K | $0 | $4K | 6.84% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DESRET INSURANCE AGENCY ADMINISTRATOR | Contract Administrator Service code 13 | 390 S MAIN ST BOUNTIFUL, UT 84010 | $9K |
| CALVIN GIBBS ADMINISTRATOR | Contract Administrator Service code 13 | 757 W 700 S WOODS CROSS, UT 84087 | $5K |
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 | 144 | 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) | 144 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | SELECT HEALTH | 316 | $1.3M |
| Dental | DENATL MANAGEMENT ADMINISTRATORS | 98 | $104K |
| Life insurance | THE HARTFORD | 144 | $65K |
| Short-term disability | THE HARTFORD | 144 | $65K |
| Long-term disability | THE HARTFORD | 144 | $65K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 316 | — |
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.