| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NIELSEN INSURANCE GROUP INC3 Filed as: NIELSEN INSURANCE GROUP | 8899 SOUTH 700 EAST, SUITE 155 SANDY, UT 84070 | SELECTHEALTH | $52K | $17K | $70K | 3.31% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFIT SERVI | 136 E SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 84111 | SELECTHEALTH | $5K | $2K | $7K | 0.34% |
| NIELSEN INSURANCE GROUP INC3 Filed as: NIELSEN INSURANCE GROUP, INC | 8899 S 700 E STE 155 SANDY, UT 84070 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $0 | $6K | 8.17% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFIT SVCS | 136 E SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 84111 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 2.78% |
| NIELSEN INSURANCE GROUP INC3 Filed as: NIELSEN INSURANCE GROUP, INC | 8899 S 700 E STE 155 SANDY, UT 84070 | HARTFORD LIFE AND ACCIDENT | $7K | $0 | $7K | 13.79% |
| CALVIN GIBBS3 Filed as: CALVIN J GIBBS CORPORATE BENEFITS | 2930 S OAKWOOD DR BOUNTIFUL, UT 84010 | HARTFORD LIFE AND ACCIDENT | -$3 | $315 | $312 | 0.59% |
| CHARLES E HAWKINS3 | 3732 EAST MILL CREEK CANYON RD SALT LAKE CITY, UT 84109 | HARTFORD LIFE AND ACCIDENT | -$3 | $215 | $212 | 0.40% |
| NIELSEN INSURANCE GROUP INC3 Filed as: NIELSEN INSURANCE GROUP | 8899 SOUTH 700 EAST, SUITE 155 SANDY, UT 84070 | EYEMED VISION CARE | $1K | $0 | $1K | 10.08% |
| NIELSEN INSURANCE GROUP INC3 Filed as: NIELSEN INSURANCE GROUP | 8899 SOUTH 700 EAST, SUITE 155 SANDY, UT 84070 | EMI HEALTH | $5K | $0 | $5K | — |
| IMA, INC.3 Filed as: IMA INC / ANGELINA MEEKS | 1705 17TH ST STE 100 DENVER, CO 80202 | EMI HEALTH | $946 | $0 | $946 | — |
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 | 183 | 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) | 183 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | SELECTHEALTH | 411 | $2.1M |
| Dental | EMI HEALTH | 404 | $0 |
| Vision | EYEMED VISION CARE | 205 | $14K |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 184 | $125K |
| Short-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 184 | $125K |
| Long-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 184 | $125K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 184 | $125K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 411 | — |
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.