| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INS BENEFIT SERVICES | 136 EAST SOUTH TEMPLE SALT LAKE CITY, UT 84111 | PRUDENTIAL INSURANCE COMPANY | $21K | — | $21K | 1.63% |
| STHEALTH BENEFIT SOLUTIONS LLC3 | 18940 NORTH PIMA ROAD,STE 210 SCOTTSDALE, AZ 85255 | UNIMERICA INSURANCE COMPANY | $62K | — | $62K | 7.00% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFIT SERVI | 136 E SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 84111 | AMERITAS LIFE INSURANCE CORP | $5K | $2K | $6K | 2.14% |
| 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) | $3K | — | $3K | 2.74% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFIT | 136 E SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 84111 | SELECTHEALTH | $97K | — | $97K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SELECTHEALTH EIN 87-0409820 CONTRACT ADMINISTRATOR | Claims processing Service code 12 | — | $770K |
| CONNECTICUT GENERAL LIFE INS(CIGNA) EIN 59-1031071 CLAIM ADMINISTRATION | Float revenue; Participant communication; Direct payment from the plan; Other services; Named fiduciary; Contract Administrator; Claims processing; Non-monetary compensation Service code 12 | — | $769K |
| PRUDENTIAL INSURANCE COMPANY EIN 22-1211670 PLAN ADMINISTRATOR | Plan Administrator Service code 14 | — | $52K |
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 | 1,902 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 17 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,919 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNIMERICA INSURANCE COMPANY | 6,928 | $883K |
| Dental(2 contracts, 2 carriers) | CONNNECTICUT GENERAL LIFE INSURANCE COMPANY (CIGNA) | 6,928 | $108K |
| Vision | AMERITAS LIFE INSURANCE CORP | 2,622 | $303K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY | 3,731 | $1.3M |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY | 3,731 | $1.3M |
| Stop-loss / reinsurancereinsurance | SELECTHEALTH | 6,928 | $0 |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY | 3,731 | $1.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 6,928 | — |
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.
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.