| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NIELSEN INSURANCE GROUP INC3 Filed as: NIELSEN INSURANCE GROUP, INC. | 8899 S 700 E STE 155 SANDY, UT 84070 | LIFEMAP ASSURANCE COMPANY | $4K | — | $4K | 9.54% |
| JACLYN PETERSON4 | 9980 S 300 W STE 100 SANDY, UT 84070 | ORRIANT, LLC | — | — | $0 | 0.00% |
| LISA NIELSEN DBA RAISE THE BAR4 | PO BOX 703 VERNAL, UT 84078 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $2K | — | $2K | 12.01% |
| HIGH POINT ALLIANCE4 | 1119 E BIRCHBROOK CIRCLE COTTONWOOD HEIGHTS, UT 84047 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $2K | — | $2K | 9.01% |
| PARRIS & ASSOCIATES4 | 4959 MEADOW BROOK RD BIRMINGHAM, AL 35242 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $82 | — | $82 | 0.41% |
| LISA A PERRI3 Filed as: LISA B NIELSEN | PO BOX 703 VERNAL, UT 84078 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 8.37% |
| BRETT GORDON BULLOCK3 | 50 WEST 700 NORTH LOGAN, UT 84321 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $611 | — | $611 | 3.60% |
| CUSTOM INSURANCE SPECIALISTS INC3 | 886 E 3200 N KAMAS, UT 84036 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $171 | $16 | $187 | 1.10% |
| ANGIE HANSEN3 | 12701 SOUTH TUSCAN SPRING LANE RIVERTON, UT 84065 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $55 | — | $55 | 0.32% |
| PATTI A VINCENT3 | 3489 WEST 10305 SOUTH SOUTH JORDAN, UT 84095 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.01% |
| LISA A PERRI3 Filed as: LISA B NIELSEN | PO BOX 703 VERNAL, UT 84078 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $774 | — | $774 | 5.58% |
| BRETT GORDON BULLOCK3 | 50 WEST 700 NORTH LOGAN, UT 84321 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $389 | — | $389 | 2.80% |
| CUSTOM INSURANCE SPECIALISTS INC3 | 886 E 3200 N KAMAS, UT 84036 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $95 | $7 | $102 | 0.74% |
| ANGIE HANSEN3 | 12701 SOUTH TUSCAN SPRING LANE RIVERTON, UT 84065 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $55 | — | $55 | 0.40% |
| PATTI A VINCENT3 | 3489 WEST 10305 SOUTH SOUTH JORDAN, UT 84095 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.01% |
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 | 160 | 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) | 160 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Short-term disability | LIFEMAP ASSURANCE COMPANY | 160 | $47K |
| Long-term disability | LIFEMAP ASSURANCE COMPANY | 160 | $47K |
| Other(4 contracts, 3 carriers) | ORRIANT, LLC | 87 | $74K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 160 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.