| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFIT | 136E SOUTH TEMPL STE 2300 SALT LAKE CITY, UT 84111 | AETNA HEALTH, INC. | $128K | $0 | $128K | 4.65% |
| DIVERSIFIED INSURANCE GROUP3 | 136E SOUTH TEMPL STE 2300 SALT LAKE CITY, UT 84111 | AETNA LIFE INSURANCE COMPANY | $9K | $0 | $9K | 3.83% |
| IMA, INC.3 Filed as: IMA INC | 136 E SOUTH TEMPLE STE 2300 1705 17TH STREET STE 100 SALT LAKE CITY, UT 84111 | HARTFORD LIFE & ACCIDENT INSURANCE COMPANY | $5K | $0 | $5K | 14.90% |
| ACRISURE LLC3 | 6307 84TH ST SE CALEDONIA, MI 49316 | HARTFORD LIFE & ACCIDENT INSURANCE COMPANY | $533 | $0 | $533 | 1.47% |
| ADSH INVESTMENTS3 Filed as: ADSH INVESTMENT II ,INC | 23716 BIRCHER DR LAKE FOREST, CA 926301771 | HARTFORD LIFE & ACCIDENT INSURANCE COMPANY | $102 | $0 | $102 | 0.28% |
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 | 480 | 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) | 480 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA HEALTH, INC. | 410 | $2.8M |
| Dental | AETNA HEALTH, INC. | 410 | $2.8M |
| Vision | AETNA HEALTH, INC. | 410 | $2.8M |
| Life insurance | HARTFORD LIFE & ACCIDENT INSURANCE COMPANY | 480 | $36K |
| Other | HARTFORD LIFE & ACCIDENT INSURANCE COMPANY | 480 | $36K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 480 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.