| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INS BENEFIT SERVICES | 136 E SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 84111 | AMERITAS LIFE INS CORP | $4K | $607 | $4K | 3.23% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFIT SERVI | 136 EAST SOUTH TEMPLE #2300 SALT LAKE CITY, UT 84111 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 11.93% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $1K | $1K | 4.00% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED BENEFIT SERVICES | 136 E SOUTH TEMPLE #2300 SALT LAKE CITY, UT 84111 | EYEMED VISION CARE | $2K | — | $2K | 9.06% |
| MAXWELL HEALTH3 | 101 TREMONT ST FL 11 BOSTON, MA 02108 | EYEMED VISION CARE | $424 | — | $424 | 1.81% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFIT SERVI | 136 EAST SOUTH TEMPLE #2300 SALT LAKE CITY, UT 84111 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 11.69% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $445 | $445 | 4.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC EIN 41-1289245 CLAIM PROCESSOR | Claims processing; Other services Service code 12 | — | $155K |
| DIVERSIFIED INSURANCE GROUP EIN 20-4442550 BROKER | Other commissions Service code 55 | — | $0 |
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 | 216 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 216 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 554 | $218K |
| Dental | AMERITAS LIFE INS CORP | 374 | $129K |
| Vision | EYEMED VISION CARE | 301 | $23K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 212 | $11K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 212 | $29K |
| Stop-loss / reinsurancereinsurance | UNITEDHEALTHCARE INSURANCE COMPANY | 554 | $218K |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 212 | $11K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 554 | — |
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.