| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FIRST WEST BENEFIT SOLUTIONS3 | 1139 S OREM BLVD OREM, UT 84058 | METROPOLITAN LIFE INSURANCE COMPANY | $11K | $591 | $11K | 1.30% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP INS SERVICES INC | 1250 S CAPITAL OF TEXAS HWY BLDG 2 AUSTIN, TX 78746 | METROPOLITAN LIFE INSURANCE COMPANY | $7K | — | $7K | 0.83% |
| HCC LIFE INSURANCE COMPANY | 225 TOWNPARK DRIVE, SUITE 350 KENNESAW, GA 30144 | HCC LIFE INSURANCE COMPANY | — | — | $0 | 0.00% |
| FIRST WEST BENEFIT SOLUTIONS3 | 1139 S OREM BLVD OREM, UT 84059 | HARTFORD LIFE AND ACCIDENT | $38K | $0 | $38K | 9.09% |
| ELYLE GRANT SWENSON3 | 7 WEST MAGELLAN LANE ELK RIDGE, UT 84651 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6K | $47 | $6K | 9.74% |
| FIRST WEST BENEFIT SOLUTIONS3 | 1139 S OREM BLVD OREM, UT 84059 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $63 | $3K | 5.50% |
| TIM VINCENT INS AGY INC3 | 3489 WEST 10305 SOUTH SOUTH JORDAN, UT 84095 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $298 | $1K | 2.35% |
| MDT GROUP LLC3 | 1044 W PARK RESERVE WAY MIDVALE, UT 84047 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SELECTHEALTH EIN 87-0409820 CONTRACT ADMINISTRATOR | Claims processing Service code 12 | 5381 GREEN ST MURRAY, UT 84123 | $363K |
| ALTIUS HEALTH PLAN EIN 87-0345631 CLAIMS ADMINISTRATOR | Plan Administrator Service code 14 | — | $315K |
| FIRST WEST BROKERAGE SERVICES BROKER | Insurance agents and brokers Service code 22 | 1139 SOUTH OREM BLVD. OREM, UT 84058 | $113K |
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 | 1,180 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,180 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HCC LIFE INSURANCE COMPANY | 801 | $765K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 2,732 | $877K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,732 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.