| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 6967 S RIVER GATE DR #200 SALT LAKE CITY, UT 84047 | DENTAL MANAGEMENT ADMINISTRATORS | $7K | $0 | $7K | 3.67% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 5295 S 300 W #550 SALT LAKE CITY, UT 84107 | BERKLEY LIFE & HEALTH INS CO | $4K | $0 | $4K | 10.04% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUM RX, INC EIN 33-0441200 PHARMACY BENEFIT MANAGER | Direct payment from the plan; Claims processing; Float revenue Service code 12 | — | $299K |
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $88K |
| GALLAGHER BENEFIT SERVICES ADMINISTRATOR | Contract Administrator Service code 13 | 6967 S RIVER GATE DR #200 MIDVALE, UT 84047 | $11K |
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 | 270 | 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) | 270 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DENTAL MANAGEMENT ADMINISTRATORS | 270 | $200K |
| Stop-loss / reinsurancereinsurance | BERKLEY LIFE & HEALTH INS CO | 270 | $38K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 270 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.