| 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 | SYMETRA LIFE INSURANCE COMPANY | $25K | — | $25K | 2.05% |
| STHEALTH BENEFIT SOLUTIONS LLC3 | 18940 NORTH PIMA ROAD,STE 210 SCOTTSDALE, AZ 85255 | UNIMERICA INSURANCE COMPANY | $80K | — | $80K | 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 | $5K | $10K | 3.01% |
| 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 | 3.04% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CONNECTICUT GENERAL LIFE INS(CIGNA) EIN 59-1031071 CLAIM ADMINISTRATION | Other services; Participant communication; Direct payment from the plan; Claims processing; Non-monetary compensation; Float revenue; Named fiduciary; Contract Administrator Service code 12 | — | $815K |
| SELECTHEALTH EIN 87-0409820 CONTRACT ADMINISTRATOR | Claims processing Service code 12 | — | $685K |
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 | 1,903 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 25 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,928 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNIMERICA INSURANCE COMPANY | 2,945 | $1.1M |
| Dental(2 contracts, 2 carriers) | CONNNECTICUT GENERAL LIFE INSURANCE COMPANY (CIGNA) | 2,945 | $106K |
| Vision | AMERITAS LIFE INSURANCE CORP | 1,260 | $337K |
| Life insurance | SYMETRA LIFE INSURANCE COMPANY | 2,775 | $1.2M |
| Long-term disability | SYMETRA LIFE INSURANCE COMPANY | 2,775 | $1.2M |
| Stop-loss / reinsurancereinsurance | SELECTHEALTH | 2,945 | $0 |
| Other(3 contracts, 3 carriers) | SYMETRA LIFE INSURANCE COMPANY | 2,775 | $1.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,945 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.