| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WORKMAN INSURANCE GROUP | 8648 ALTA COVE DRIVE SANDY, UT 84093 | SELECT HEALTH | $16K | — | $16K | 3.58% |
| WORKMAN INSURANCE GROUP | 8648 ALTA COVE DRIVE SANDY, UT 84093 | DENTIST DIRECT, LLC | $2K | — | $2K | 5.99% |
| WORKMAN INSURANCE GROUP | 8648 S ALTA COVE DRIVE SANDY, UT 84093 | HEALTHIEST YOU | $2K | — | $2K | 15.00% |
| WORKMAN INSURANCE GROUP | 8648 ALTA COVE DRIVE SANDY, UT 84093 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $580 | — | $580 | 9.39% |
| WORKMAN INSURANCE GROUP Filed as: WORKMAN INSURANCE GROUP, LLC | PO BOX 901298 SANDY, UT 84090 | AMALGAMATED LIFE | $480 | — | $480 | 9.54% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| LAURA K. SMITH EIN 57-2934724 UNION MEMBER | Employee (plan) Service code 30 | 3878 HALLMARK DRIVE WEST VALLEY CITY, UT 84119 | $34K |
| DAN HUTTEN UNION MEMBER | Plan Administrator Service code 14 | 173 Q STREET SALT LAKE CITY, UT 84103 | $28K |
| HAYNIE & COMPANY EIN 87-0325228 AUDITOR | Accounting (including auditing) Service code 10 | 50 WEST BROADWAY SUITE 600 SALT LAKE CITY, UT 84101 | $18K |
| ROBERT CHASE EIN 52-8889380 UNION MEMBER (PART YEAR) | Employee (plan) Service code 30 | 3416 SOUTH 2410 EAST SALT LAKE CITY, UT 84109 | $14K |
| SORENSEN, VANCE, AND COMPANY EIN 87-0439430 AUDITOR | Accounting (including auditing) Service code 10 | 3115 EAST LION LANE SUITE 220 SALT LAKE CITY, UT 84121 | $10K |
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 | 1,105 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | SELECT HEALTH | 90 | $460K |
| Dental | DENTIST DIRECT, LLC | 69 | $29K |
| Life insurance(2 contracts, 2 carriers) | FIDELITY SECURITY LIFE INSURANCE COMPANY | 96 | $11K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 96 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.