| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFITS | 136 E SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 84117 | SELECTHEALTH | $27K | $9K | $36K | 3.23% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFIT SERV | 136 E SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 84117 | SELECTHEALTH | $15K | $4K | $19K | 3.05% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED BENEFIT INSURANCE SERV | 136 E SOUTH TEMPLE SALT LAKE CITY, UT 84111 | EDUCATORS MUTUAL PLANS LIFE, ACCIDENT AND HEALTH, INC | $3K | $0 | $3K | 5.46% |
| GBS BENEFITS INS AGENCY3 Filed as: GBS BENEFITS/TRENT SANDERS | 465 S 400 E SUITE 300 SALT LAKE CITY, UT 84111 | EDUCATORS MUTUAL PLANS LIFE, ACCIDENT AND HEALTH, INC | $323 | $0 | $323 | 0.63% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INS BEN SERV/ NIELSEN | 136 E SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 84117 | ACE USA GROUP | $2K | $0 | $2K | 6.96% |
| DIVERSIFIED INSURANCE GROUP3 | 136 EAST SOUTH TEMPLE #2300 SALT LAKE CITY, UT 84111 | OPTICARE OF UTAH | $428 | $0 | $428 | 10.00% |
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 | 110 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 110 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | SELECTHEALTH | 292 | $1.7M |
| Dental(2 contracts, 2 carriers) | EDUCATORS MUTUAL PLANS LIFE, ACCIDENT AND HEALTH, INC | 212 | $74K |
| Vision | OPTICARE OF UTAH | 56 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 292 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.