| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIVERSIFIED INSURANCE GROUP3 | 136 E SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 841111117 | KAISER FOUNDATION HEALTH PLAN INC | $48K | $8K | $55K | 1.12% |
| JENNA LYN HUTCHINGS3 | 136 E SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 841111117 | KAISER FOUNDATION HEALTH PLAN INC | $1K | $0 | $1K | 0.03% |
| STEALTH PARTNER GROUP LLC3 Filed as: STEALTH PARTNER GROUP | 18940 NORTH PIMA ROAD, SUITE 210 BLDG 2, SUITE 4045 SCOTTSDALE, AZ 85255 | QBE INSURANCE | — | $73K | $73K | 7.00% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFIT SERVI | 136 EAST SOUTH TEMPLE SALT LAKE CITY, UT 84111 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $18K | $12K | $30K | 2.91% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFIT SERVI | 136 E SOUTH TEMPLE SALT LAKE CITY, UT 84111 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $128K | $11K | $138K | 15.97% |
| JEANA HUTCHINGS3 Filed as: JEANA L HUTCHINGS | 136 E SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 84111 | UNITEDHEALTHCARE INSURANCE COMPANY | $3K | $0 | $3K | 0.96% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFIT SERVI | 136 E SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 841111117 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $29K | $2K | $31K | 15.83% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFIT SERVI | 136 E SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 841111117 | AMERITAS LIFE INSURANCE CORP | $0 | $4K | $4K | 2.25% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFIT SERVI | 136 E SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 841111117 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $1K | $8K | 6.47% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES INC EIN 41-1289245 CLAIMS PROCESSOR | Claims processing; Other services Service code 12 | — | $998K |
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 151 FARMINGTON AVENUE HARTFORD, CT 06156 | $485K |
| AMERITAS LIFE INSURANCE CORP EIN 47-0098400 CLAIMS PROCESSOR | Other services; Claims processing Service code 12 | PO BOX 81889 LINCOLN, NE 685011889 | $74K |
| 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 | 4,319 | 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) | 4,319 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 1,099 | $345K |
| Vision(2 contracts) | AMERITAS LIFE INSURANCE CORP | 2,798 | $221K |
| Life insurance(4 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 3,307 | $2.2M |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 3,307 | $1.0M |
| Long-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 3,307 | $1.1M |
| Stop-loss / reinsurancereinsurance | QBE INSURANCE | 1,977 | $1.0M |
| Other(6 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 3,307 | $2.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,307 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.