| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIVERSIFIED INSURANCE GROUP3 | 95 S STATE ST STE 1300 SALT LAKE CITY, UT 841111659 | KAISER FOUNDATION HEALTH PLAN, INC. | $4K | — | $4K | 4.50% |
| HUTCHINGS, JEANA L3 Filed as: HUTCHINGS, JEANNA | 95 SOUTH STATE ST. SUITE 1300 SALT LAKE CITY, UT 84111 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $6K | — | $6K | 7.39% |
| DIVERSIFIED INSURANCE GROUP3 | 136 E SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 84111 | SUN LIFE ASSURANCE COMPANY OF CANADA | $6K | — | $6K | 8.09% |
| WATCHTOWER TECHNOLOGIES INC3 | 306 W ERIE ST SUITE 300 CHICAGO, IL 60654 | SUN LIFE ASSURANCE COMPANY OF CANADA | $0 | $875 | $875 | 1.11% |
| IMA, INC.3 Filed as: IMA INC | 136 E SOUTH TEMPLE #2300 SALT LAKE CITY, UT 84111 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 21.28% |
| IMA, INC.3 | DIVERSIFIED INSURANCE GROUP 136 EAST SOUTH TEMPLE, SUITE 2300 SALT LAKE CITY, UT 84111 | METLIFE LEGAL PLANS | $217 | — | $217 | 6.61% |
| IMA, INC.3 | 136 EAST SOUTH TEMPLE, SUITE 2300 SALT LAKE CITY, UT 84111 | METLIFE LEGAL PLANS | $0 | $201 | $201 | 6.13% |
| IMA, INC.3 | DIVERSIFIED INSURANCE GROUP 95 SOUTH STATE ST, SUITE 1300 SALT LAKE CITY, UT 84111 | METLIFE LEGAL PLANS | $28 | — | $28 | 0.85% |
| ASSUREDPARTNERS3 Filed as: THE SIMKISS AGENCY | 1041 OLD CASSATT RD BERWYN, PA 19312 | METLIFE LEGAL PLANS | $28 | — | $28 | 0.85% |
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 | 120 | 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) | 120 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 43 | $107K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 100 | $83K |
| Vision | SUN LIFE ASSURANCE COMPANY OF CANADA | 120 | $79K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 120 | $79K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 120 | $79K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 120 | $79K |
| Other(3 contracts, 3 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 120 | $102K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 120 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.