| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFIT SVCS. | 136 EAST SOUTH TEMPLE SALT LAKE CITY, UT 84111 | AETNA LIFE INSURANCE COMPANY | $0 | $102K | $102K | 2.93% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4000 MIDLANTIC AVENUE MOUNT LAUREL, NJ 08054 | AETNA LIFE INSURANCE COMPANY | $20K | $29K | $49K | 1.41% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFIT SVCS. | 93 SOUTH STATE STREET SALT LAKE CITY, UT 84111 | AETNA LIFE INSURANCE COMPANY | -$20K | $0 | -$20K | -0.58% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFIT SVCS. | 136 EAST SOUTH TEMPLE, SUITE 2300 SALT LAKE CITY, UT 84111 | SUN LIFE ASSURANCE COMPANY OF CANADA | $8K | $0 | $8K | 6.65% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | SUN LIFE ASSURANCE COMPANY OF CANADA | $6K | $0 | $6K | 4.60% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFIT SVCS. | 95 SOUTH STATE STREET, SUITE 1300 SALT LAKE CITY, UT 84111 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $0 | $4K | 10.46% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | METROPOLITAN LIFE INSURANCE COMPANY | $277 | $0 | $277 | 0.78% |
| DIVERSIFIED INSURANCE GROUP4 Filed as: DIVERSIFIED INSURANCE BENEFIT SVCS. | 136 EAST SOUTH TEMPLE, SUITE 2300 SALT LAKE CITY, UT 84111 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $2K | $0 | $2K | 18.55% |
| D'ANN DABELL4 | 1174 NORTH 2000 EAST LAYTON, UT 84040 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $2K | $0 | $2K | 11.62% |
| KIMBERLY N. HARDIN4 | 8455 DANIELS STREET, APARTMENT 1L BRIARWOOD, NY 11435 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $166 | $0 | $166 | 1.27% |
| GALLAGHER BENEFIT SERVICES, INC.4 | 6967 SOUTH RIVER GATE DRIVE SUITE 200 MIDVALE, UT 84047 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $20 | $0 | $20 | 0.15% |
No Schedule C service providers reported on this filing.
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 | 508 | 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) | 508 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 664 | $3.5M |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 840 | $36K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 508 | $127K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 508 | $127K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 508 | $127K |
| Other(3 contracts, 3 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 508 | $149K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 840 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.