| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 6967 SOUTH RIVER GATE DRIVE SUITE 200 MIDVALE, UT 84047 | SELECTHEALTH | $44K | $11K | $55K | 4.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | HARTFORD LIFE AND ACCIDENT | $9K | $1K | $10K | 11.95% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 6340 SOUTH 3000 EAST, SUITE 500 SALT LAKE CITY, UT 84121 | EDUCATORS MUTUAL PLANS LIFE, ACCIDENT AND HEALTH, INC. | $5K | $0 | $5K | 6.00% |
| DARRELL RAWLINS3 | 8338 MESA DRIVE SANDY, UT 84093 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $6K | $0 | $6K | 32.69% |
| BRETT BULLOCK3 | 10219 SOUTH 670 WEST PARADISE, UT 84328 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $262 | $0 | $262 | 1.42% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 6967 SOUTH RIVER GATE DRIVE SUITE 200 SALT LAKE CITY, UT 84047 | OPTICARE VISION SERVICES | $661 | $0 | $661 | 10.01% |
| DARRELL RAWLINS3 | 8338 SOUTH MESA DRIVE SANDY, UT 84093 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $422 | $0 | $422 | 18.88% |
| CUSTOM INSURANCE SPECIALISTS INC3 Filed as: CUSTOM INSURANCE SPECIALISTS INC. | 886 EAST 3200 NORTH KAMAS, UT 84036 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $210 | $33 | $243 | 10.87% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 6967 SOUTH RIVER GATE DRIVE SALT LAKE CITY, UT 84047 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $218 | $8 | $226 | 10.11% |
| DESIREE ROBERTSON3 | 5691 SOUTH STONE BLUFF WAY TAYLORVILLE, UT 84118 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $48 | $1 | $49 | 2.19% |
| JILL HUGHES3 | 6510 TAMARA DRIVE SALT LAKE CITY, UT 84118 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $29 | $2 | $31 | 1.39% |
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 | 146 | 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) | 146 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | SELECTHEALTH | 227 | $1.1M |
| Dental | EDUCATORS MUTUAL PLANS LIFE, ACCIDENT AND HEALTH, INC. | 266 | $80K |
| Vision | OPTICARE VISION SERVICES | 39 | $7K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 137 | $83K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 4 | $2K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 137 | $83K |
| Prescription drug | SELECTHEALTH | 227 | $1.1M |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 137 | $102K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 266 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.