No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CVS CAREMARK/RX AMERICA EIN 87-0548860 NONE | Claims processing Service code 12 | 61E CVS DRIVE WOONSOCKET, RI 02895 | $2.0M |
| MULTIPLAN | Claims processing Service code 12 | 115 FIFTH AVENUE NEW YORK, NY 10003 | $291K |
| JAS, INC. EIN 87-0435473 NONE | Plan Administrator; Contract Administrator Service code 13 | 4885 S 900 E STE 202 SALT LAKE CITY, UT 84117 | $166K |
| AETNA LIFE DBA FIRST HEALTH NONE | Claims processing Service code 12 | 10150 S CENTENNIAL PKWY SANDY, UT 84070 | $116K |
| IMAGINE HEALTH NONE | Claims processing Service code 12 | 6995 UNION PARK CENTER COTTONWOOD HEIGHTS, UT 84047 | $101K |
| SEGAL SELECT INSURANCE SERVICES,INC EIN 46-0619194 NONE | Insurance brokerage commissions and fees Service code 53 | 333 WEST 34TH STREET NEW YORK, NY 100012402 | $91K |
| AMERICAN HEALTH GROUP, INC. NONE | Claims processing Service code 12 | 2152 S VINEYARD 103 MESA, AZ 85210 | $62K |
| SOUTHWEST SERVICE ADMINISTRATORS NONE | Contract Administrator; Plan Administrator Service code 13 | 2550 W UNION HILLS DR290 PHOENIX, AZ 85027 | $56K |
| SPENCER FANE, LLP NONE | Legal Service code 29 | 370 17TH STREET 4800 DENVER, CO 80202 | $55K |
| BLOMQUIST HALE CONSULTING EIN 87-0462684 NONE | Insurance services Service code 23 | 860 E 4500 S STE 202 SALT LAKE CITY, UT 84107 | $52K |
| WSRP, LLC EIN 87-0517754 NONE | Accounting (including auditing) Service code 10 | 155 N 400 W 400 SALT LAKE CITY, UT 84103 | $30K |
| KENNETH B GRIMES, P.C. EIN 90-0188484 NONE | Legal Service code 29 | 142 E 200 S STE 312 SALT LAKE CITY, UT 84111 | $29K |
| CAREOPERATIVE, LLC NONE | Claims processing Service code 12 | 330 FRANKLIN RD, STE 135A BRENTWOOD, TN 37027 | $26K |
| PRESCRIPTION CARE MANAGEMENT NONE | Claims processing Service code 12 | PO BOX 3446 RENO, NV 895334446 | $22K |
| US BANK EIN 93-0826646 NONE | Trustee (bank, trust company, or similar financial institution) Service code 21 | PO BOX 287 PORTLAND, OR 97208 | $20K |
| ALTA CAPITAL MANAGEMENT EIN 77-0650218 NONE | Investment management Service code 28 | 6440 S WASATCH BLVD SALT LAKE CITY, UT 84121 | $17K |
| AGINCOURT CAPITAL NONE | Investment management Service code 28 | 200 S 10TH ST STE 800 RICHMOND, VA 23219 | $13K |
| WELLS FARGO ADVISORS EIN 34-1542819 NONE | Investment management Service code 28 | 201 S MAIN ST STE 160 SALT LAKE CITY, UT 84111 | $8K |
| BERENBAUM WEINSHIENK PC NONE | Legal Service code 29 | 370 17TH STREET 4800 DENVER, CO 80202 | $6K |
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 | 1,053 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 58 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,111 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 1,118 | $282K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,118 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported — worth a knock.