| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 6967 SOUTH RIVERGATE DRIVE SUITE 200 MIDVALE, UT 84047 | SELECTHEALTH | $29K | $10K | $39K | 3.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | HARTFORD LIFE AND ACCIDENT | $13K | $0 | $13K | 12.65% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HUMAN RESOURCE CONSULTING | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HARTFORD LIFE AND ACCIDENT | $125 | $395 | $520 | 0.49% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 6967 SOUTH RIVER GATE DRIVE SUITE 200 MIDVALE, UT 84047 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $7K | $0 | $7K | 6.95% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 111 VETERANS BOULEVARD, SUITE 1130 METAIRIE, LA 70005 | CONTINENTAL AMERICAN INSURANCE COMPANY | $6K | $0 | $6K | 32.54% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS ADMIN. | PO BOX 310502 DES MOINES, IA 50331 | CONTINENTAL AMERICAN INSURANCE COMPANY | $686 | — | $686 | 3.61% |
| NEENA W BEVERLY3 Filed as: NEENA WITT BEVERLY | 1888 EAST 6400 SOUTH HOLLADAY, UT 84121 | CONTINENTAL AMERICAN INSURANCE COMPANY | $64 | $0 | $64 | 0.34% |
| CRICKET INSURANCE CORPORATION3 | 6573 SOUTH EVENING GLOW COURT WEST VALLEY, UT 84081 | CONTINENTAL AMERICAN INSURANCE COMPANY | $17 | $0 | $17 | 0.09% |
| TYLER KOHLER3 Filed as: TYLER REED KOHLER | 1323 EAST BENT PINE COVE DRAPER, UT 84020 | CONTINENTAL AMERICAN INSURANCE COMPANY | $13 | $0 | $13 | 0.07% |
| JERRY HOKE3 Filed as: JERRY FRANKLIN HOKE | 517 EAST 3270 NORTH LEHI, UT 84043 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1 | $0 | $1 | 0.01% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $60 | $0 | $60 | 0.74% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 200 JEFFERSON PARK WHIPPANY, NJ 07981 | PRINCIPAL LIFE INSURANCE COMPANY | $614 | $0 | $614 | 9.78% |
| D'ANN DABELL4 Filed as: D. ANN DABELL | 1174 NORTH 2000 EAST LAYTON, UT 84040 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $329 | $0 | $329 | 7.31% |
| HIGH POINT ALLIANCE4 | 1119 EAST BIRCHBROOK CIRCLE COTTONWOOD HEIGHTS, UT 84047 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $186 | $0 | $186 | 4.13% |
| JUDY E. BAIRD4 | PO BOX 938 KAMAS, UT 84036 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $154 | $0 | $154 | 3.42% |
| MERCER HEALTH AND BENEFITS, LLC4 Filed as: MERCER HEALTH AND BENEFITS ADMIN. | PO BOX 850502 MINNEAPOLIS, MN 55485 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $143 | $0 | $143 | 3.18% |
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 | 99 | 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) | 99 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | SELECTHEALTH | 224 | $969K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 81 | $94K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 90 | $8K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 100 | $105K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 15 | $6K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 100 | $105K |
| Prescription drug | SELECTHEALTH | 224 | $969K |
| Other(4 contracts, 4 carriers) | HARTFORD LIFE AND ACCIDENT | 100 | $135K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 224 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.