| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JENNA LYN HUTCHINGS3 | 136 E SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 841111117 | KAISER FOUNDATION HEALTH PLAN | $25K | — | $25K | 0.96% |
| DIVERSIFIED INSURANCE GROUP3 | 136 E SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 841111117 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $23K | $23K | 1.41% |
| JEANA HUTCHINGS3 | 136 E SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 84111 | AETNA HEALTH INC | $11K | — | $11K | 0.91% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFIT SERVI | 136 E SOUTH TEMPLE SALT LAKE CITY, UT 84111 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $101K | $9K | $109K | 16.34% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFIT SERVI | 136 EAST SOUTH TEMPLE SALT LAKE CITY, UT 84111 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $15K | $8K | $22K | 3.69% |
| JEANA HUTCHINGS3 | 136 E SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 84111 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $2K | — | $2K | 0.99% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFIT | 136 EAST SOUTH TEMPLE SALT LAKE CITY, UT 84111 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $28K | $3K | $31K | 18.87% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFIT SERVI | 136 E SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 841111117 | AMERITAS LIFE INSURANCE CORP | — | $990 | $990 | 0.68% |
| JEANA HUTCHINGS3 | 136 E SOUTH TEMPLE SALT LAKE CITY, UT 84111 | AETNA LIFE INSURANCE CO | $1K | — | $1K | 0.87% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFIT | 136 E SOUTH TEMPLE SALT LAKE CITY, UT 84111 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $2K | $9K | 9.31% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AMERITAS LIFE INSURANCE CORP EIN 47-0098400 CLAIMS PROCESSOR | Claims processing; Other services Service code 12 | PO BOX 81889 LINCOLN, NE 685011889 | $67K |
| DIVERSIFIED INSURANCE BENEFIT SERVI EIN 20-4442550 BROKER | Other commissions Service code 55 | 136 E SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 841111117 | $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 | 3,996 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,005 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 243 | $1.8M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 680 | $246K |
| Vision(2 contracts) | AMERITAS LIFE INSURANCE CORP | 2,541 | $193K |
| Life insurance(4 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,875 | $1.5M |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,875 | $609K |
| Long-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,875 | $702K |
| Other(5 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,875 | $1.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,875 | — |
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.