| 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 | $5K | — | $5K | 9.32% |
| LISA A PERRI3 Filed as: LISA B NIELSEN | 5722 JORDAN CANAL ROAD TAYLORSVILLE, UT 84129 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 6.54% |
| BRETT GORDON BULLOCK3 | 50 WEST 700 NORTH LOGAN, UT 84321 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $668 | — | $668 | 2.98% |
| CUSTOM INSURANCE SPECIALISTS INC3 | 886 E 3200 N KAMAS, UT 84036 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $174 | $22 | $196 | 0.87% |
| ANGIE HANSEN3 | 12701 SOUTH TUSCAN SPRING LANE RIVERTON, UT 84065 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $148 | — | $148 | 0.66% |
| MDT GROUP LLC3 | 4588 GREENBROOK COURT TAYLORSVILLE, UT 84123 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | — | $14 | 0.06% |
| PATTI A VINCENT3 | 3489 WEST 10305 SOUTH SOUTH JORDAN, UT 84095 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.02% |
| LISA A PERRI3 Filed as: LISA B NIELSEN | 5722 JORDAN CANAL ROAD TAYLORSVILLE, UT 84129 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $794 | — | $794 | 5.02% |
| BRETT GORDON BULLOCK3 | 50 WEST 700 NORTH LOGAN, UT 84321 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $359 | — | $359 | 2.27% |
| CUSTOM INSURANCE SPECIALISTS INC3 | 886 E 3200 N KAMAS, UT 84036 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $114 | $13 | $127 | 0.80% |
| ANGIE HANSEN3 | 12701 SOUTH TUSCAN SPRING LANE RIVERTON, UT 84065 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $78 | — | $78 | 0.49% |
| MDT GROUP LLC3 | 4588 GREENBROOK COURT TAYLORSVILLE, UT 84123 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $25 | — | $25 | 0.16% |
| PATTI A VINCENT3 | 3489 WEST 10305 SOUTH SOUTH JORDAN, UT 84095 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.01% |
| LISA NIELSEN DBA RAISE THE BAR4 | PO BOX 18534 SALT LAKE CITY, UT 84118 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $1K | — | $1K | 10.71% |
| HIGH POINT ALLIANCE4 | 1119 E BIRCHBROOK CIRCLE COTTONWOOD HEIGHTS, UT 84047 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $962 | — | $962 | 7.51% |
| PARRISH & ASSOCIATES4 | 4959 MEADOW BROOK RD BIRMINGHAM, AL 35242 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $59 | — | $59 | 0.46% |
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 | 178 | 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) | 178 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Short-term disability | LIFEMAP ASSURANCE COMPANY | 178 | $52K |
| Long-term disability | LIFEMAP ASSURANCE COMPANY | 178 | $52K |
| Other(3 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 66 | $51K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 178 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.