Form 5500 · Employee benefit plan · WEST JORDAN, UT
X3 STAFFING, INC.
The filing calls this plan X3 STAFFING, INC.WELFARE BENEFIT PLAN.
X3 STAFFING, INC. of WEST JORDAN, UT spreads its employee benefits across 3 insurance carriers, according to its Form 5500 Schedule A. Its broker of record is CELIA NASH INSURANCE. Coverage is written through SELECTHEALTH and 2 other carriers. The plan's most recent policy period ended in October.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 47-4487183 · plan 501 · plan year 2025, filed Jul 27, 2026
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How this plan is funded
Fully insured as reported
The filing reports medical coverage through an insurance contract on Schedule A, and no money paid for benefits by the plan itself.
Benefits declared on this filing
Also declared: death benefits, other welfare.
Declared benefits are the plan’s own line 8b codes on Form 5500. “Not on Schedule A” means no insured contract for that line appears on this filing. That usually means the benefit is self-funded, or it sits under a different plan number.
Persons covered is the count the carrier filed for that policy at the end of its policy year, and it can include dependents. Participants is the plan's own count at the start of its plan year. The two count different people, so a covered figure can be larger.
Plan brief
Schedule A lists 3 insured contracts covering health, dental, vision, life and disability; the largest, with SELECTHEALTH, covers 242 people.
Reported premium across the insured contracts is $1,320,038, with $84,489 in disclosed broker commissions — about 6.4% of premium.
The most recent policy period ended in October, and the plan year ends October 31. Group contracts typically renew on that annual cycle.
CELIA NASH INSURANCE is the broker of record on all 3 contracts.
3 carriers appear on the filing, including SELECTHEALTH, HARTFORD LIFE AND ACCIDENT and SAMERA / TOWN AND COUNTRY LIFE INSURANCE COMPANY. SELECTHEALTH writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| SELECTHEALTH | Health | 242 | Nov 1, 2025 | $1,166,063 | $65,799 |
| HARTFORD LIFE AND ACCIDENT | Life, Disability | 350 | Nov 1, 2025 | $85,648 | $11,857 |
| SAMERA / TOWN AND COUNTRY LIFE INSURANCE COMPANY | Dental, Vision | 135 | Nov 1, 2025 | $68,327 | $6,833 |
Covered = persons covered at policy year end, as filed on Schedule A for that policy — often certificates or one class, not the whole plan. Premium = the filing’s own premium/charges figure; “—” means not credibly reported.
Administrator and service providers
The plan administrator is from line 3a of the main form. We publish company names only.
Other plans filed by this employer
How this plan compares
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