| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GBS BENEFITS INC3 | 2200 S MAIN ST STE 600 SOUTH SALT LAKE, UT 84115 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $169K | — | $169K | 21.46% |
| GBS BENEFITS INC3 | 465 S 400 E STE 300 SALT LAKE CITY, UT 84111 | UNITED OF OMAHA LIFE INSURANCE CO. | $41K | — | $41K | 14.55% |
| GBS BENEFITS INC3 | 2200 S MAIN ST STE 600 SOUTH SALT LAKE, UT 84115 | OPTICARE VISION SERVICES | $6K | — | $6K | 17.33% |
| GBS BENEFITS INC3 | 2200 S MAIN ST STE 600 SOUTH SALT LAKE, UT 84115 | AMERITAS LIFE INSURANCE CORP. | $4K | — | $4K | 18.20% |
| GBS BENEFITS INC3 | 2200 S MAIN ST STE 600 SOUTH SALT LAKE, UT 84115 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $3K | $963 | $4K | 26.44% |
| TEMPO HOLDINGS COMPANY LLC3 | 4 OVERLOOK POINT LINCOLNSHIRE, IL 60069 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $747 | $747 | 5.00% |
| GBS BENEFITS INC3 | 2200 S MAIN ST STE 600 SOUTH SALT LAKE, UT 84115 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $3K | $1K | $4K | 29.32% |
| TEMPO HOLDINGS COMPANY LLC3 | 4 OVERLOOK POINT LINCOLNSHIRE, IL 60069 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $701 | $701 | 5.00% |
| GBS BENEFITS INC3 | 2200 S MAIN ST STE 600 SOUTH SALT LAKE, UT 84115 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $3K | $866 | $4K | 26.42% |
| TEMPO HOLDINGS COMPANY LLC3 | 4 OVERLOOK POINT LINCOLNSHIRE, IL 60069 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $674 | $674 | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 SERVICE PROVIDER | Other services; Participant communication; Direct payment from the plan; Claims processing; Non-monetary compensation; Float revenue; Named fiduciary; Contract Administrator Service code 12 | — | $90K |
| CIGNA HEALTH AND INSURANCE CO. | Contract Administrator; Direct payment from the plan; Claims processing; Other services; Participant communication; Named fiduciary; Non-monetary compensation; Float revenue Service code 12 | — | $0 |
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 | 349 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 349 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 312 | $819K |
| Dental | AMERITAS LIFE INSURANCE CORP. | 301 | $19K |
| Vision | OPTICARE VISION SERVICES | 921 | $32K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE CO. | 349 | $280K |
| Short-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE CO. | 349 | $295K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE CO. | 349 | $280K |
| Other(4 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE CO. | 349 | $321K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 921 | — |
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.