| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIVERSIFIED INSURANCE GROUP3 | 136 E SOUTH TEMPLE SALT LAKE CITY, UT 84111 | AETNA LIFE INSURANCE CO. | $128K | $0 | $128K | 3.65% |
| DIVERSIFIED INSURANCE GROUP3 | 136 E SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 84111 | DENTAL SELECT | $22K | $0 | $22K | 6.00% |
| DIVERSIFIED INS BNFT SVCS3 | 136 EAST SOUTH TEMPLE #2300 SALT LAKE CITY, UT 84111 | SUN LIFE ASSURANCE COMPANY OF CANADA | $12K | $0 | $12K | 9.41% |
| DIVERSIFIED INSURANCE GROUP3 | 136 EAST SOUTH TEMPLE STE 2300 STE 2300 SALT LAKE CITY, UT 84111 | SUPERIOR VISION | $5K | $0 | $5K | 10.28% |
| IMA, INC.3 Filed as: IMA, INC | 136 EAST SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 84111 | GUARDIAN | $8K | $3K | $11K | 24.25% |
| DIVERSIFIED INSURANCE GROUP3 | 136 EAST SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 84111 | SUN LI AND HEALTH INSURANCE | $542 | $0 | $542 | 2.59% |
| DIVERSIFIED INSURANCE GROUP4 | 136 EAST SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 84111 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $3K | $0 | $3K | 19.60% |
| DANN DABELL4 | 1174 N 2000 E LAYTON, UT 84040 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $2K | $0 | $2K | 10.90% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DIVERSIFIED INSURANCE BENEFIT SERVI SERVICE | Other fees Service code 99 | 136 E SOUTH TEMPLE SALT LAKE CITY, UT 84111 | $128K |
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 | 851 | 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) | 851 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE CO. | 851 | $3.5M |
| Dental | DENTAL SELECT | 389 | $373K |
| Vision | SUPERIOR VISION | 316 | $46K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 543 | $128K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 543 | $128K |
| Other(4 contracts, 4 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 543 | $209K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 851 | — |
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."
No prospect flags tripped on this filing.