| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFIT | 136 E SOUTH TEMPLE SALT LAKE CITY, UT 84111 | UNUM LIFE INSURANCE CO. OF AMERICA | $15K | $8K | $23K | 2.80% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFIT | 136 E SOUTH TEMPLE SALT LAKE CITY, UT 84111 | UNUM LIFE INSURANCE CO. OF AMERICA | $4K | $6K | $11K | 2.07% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFIT SERVI | 136 E SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 84111 | AMERITAS LIFE INSURANCE CORP | $3K | $2K | $5K | 2.41% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFIT SERVI | 136 E SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 84111 | CONNNECTICUT GENERAL LIFE INSURANCE COMPANY (CIGNA) | $64K | — | $64K | 62.57% |
| STEALTH PARTNER GROUP LLC3 Filed as: STEALTH BENEFIT SOLUTIONS LLC | 18940 NORTH PIMA RD STE 210 SCOTTSDALE, AZ 85260 | SYMETRA LIFE INSURANCE CO. | $0 | $4K | $4K | 11.34% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFIT | 136 E SOUTH TEMPLE SALT LAKE CITY, UT 84111 | FIRST UNUM LIFE INSURANCE COMPANY | — | $12 | $12 | 1.28% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFIT | 136 E SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 84111 | SELECTHEALTH | $106K | — | $106K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SELECTHEALTH EIN 87-0409820 CONTRACT ADMINISTRATOR | Claims processing Service code 12 | — | $723K |
| CONNECTICUT GENERAL LIFE INS(CIGNA) EIN 59-1031071 CLAIM ADMINISTRATION | Other services; Non-monetary compensation; Claims processing; Direct payment from the plan; Float revenue; Named fiduciary; Participant communication; Contract Administrator Service code 12 | — | $648K |
| UNUM LIFE INSURANCE COMPANY OF AMER EIN 01-0278678 PLAN ADMINISTRATOR | Plan Administrator Service code 14 | — | $48K |
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 | 2,479 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 433 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 2,912 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | SELECTHEALTH | 3,031 | $0 |
| Dental(2 contracts, 2 carriers) | CONNNECTICUT GENERAL LIFE INSURANCE COMPANY (CIGNA) | 3,031 | $102K |
| Vision | AMERITAS LIFE INSURANCE CORP | 2,514 | $207K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE CO. OF AMERICA | 2,535 | $1.3M |
| Short-term disability(2 contracts) | UNUM LIFE INSURANCE CO. OF AMERICA | 2,535 | $1.3M |
| Long-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE CO. OF AMERICA | 2,535 | $513K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | SYMETRA LIFE INSURANCE CO. | 3,031 | $35K |
| Other(2 contracts, 2 carriers) | AMERITAS LIFE INSURANCE CORP | 2,514 | $309K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,031 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.