| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIVERSIFIED INSURANCE3 | 136 E SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 84111 | ACE AMERICAN INSURANCE COMPANY | $11K | $0 | $11K | 6.99% |
| DIVERSIFIEDINSURANCE BENEFIT3 | 136 E SOUTH TEMPLE SALT LAKE CITY, UT 84111 | GUARDIANS | $9K | $0 | $9K | 20.00% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BEN | 136 E SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 84111 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $0 | $4K | 10.00% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $1K | $1K | 4.00% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BEN | 136 E SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 84111 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $0 | $3K | 10.00% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $1K | $1K | 4.00% |
| DIVERSIFIED INSURANCE GROUP3 | 136 EAST SOUTH TEMPLE #2300 SALT LAKE CITY, UT 84111 | OPTICARE OF UTAH | $2K | $0 | $2K | 10.00% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BEN | 136 E SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 84111 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $0 | $1K | 10.00% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $503 | $503 | 4.00% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BEN | 136 E SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 84111 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $475 | $0 | $475 | 10.01% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $190 | $190 | 4.00% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED BENEFIT INSURANCE SERVI | JEANA HUTCHINGS 136 E SOUTH TEMPLE SALT LAKE CITY, UT 84111 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $0 | $0 | $0 | — |
| DIVERSIFIED INSURANCE3 | 136 E SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 84111 | SELECT HEALTH | $109K | $0 | $109K | — |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INS BENEFIT SVCS | 136 E SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 84111 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $0 | $0 | $0 | — |
| NIELSEN INSURANCE GROUP INC3 Filed as: NIELSEN INS GROUP INC | 8899 SOUTH 700 EAST SUITE 155 SANDY, UT 84070 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $0 | $0 | $0 | — |
| COLEMAN LLOYD3 | 4847 W SOUTH JORDAN PKWY SOUTH JORDAN, UT 84009 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $0 | $0 | $0 | — |
| BALLIF DAVID3 | 648 HILLSIDE CIR ALPINE, UT 84004 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $0 | $0 | $0 | — |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INS BENEFIT SVCS | 136 E SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 84111 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $0 | $0 | $0 | — |
| NIELSEN INSURANCE GROUP INC3 Filed as: NIELSEN INS GROUP INC | 8899 SOUTH 700 EAST SUITE 155 SANDY, UT 84070 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $0 | $0 | $0 | — |
| COLEMAN LLOYD3 | 4847 W SOUTH JORDAN PKWY SOUTH JORDAN, UT 84009 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $0 | $0 | $0 | — |
| BALLIF DAVID3 | 648 HILLSIDE CIR ALPINE, UT 84004 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $0 | $0 | $0 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SELECT HEALTH EIN 87-0409820 CONTRACT ADMINISTRATOR | Claims processing Service code 12 | — | $257K |
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 | 536 | 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) | 536 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | SELECT HEALTH | 536 | $0 |
| Dental | ACE AMERICAN INSURANCE COMPANY | 215 | $152K |
| Vision | OPTICARE OF UTAH | 153 | $15K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $36K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $5K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $32K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 256 | $337K |
| Other(6 contracts, 3 carriers) | GUARDIANS | 103 | $93K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 536 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.