| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFIT SVCS | 136 E. SOUTH TEMPLE #2300 SALT LAKE CITY, UT 84111 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $52K | $65K | $117K | 28.55% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFITS | 136 E. SOUTH TEMPLE #2300 SALT LAKE, UT 84111 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $1K | $3K | 15.76% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $784 | $784 | 4.00% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFITS | 136 E. SOUTH TEMPLE #2300 SALT LAKE, UT 84111 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $759 | $2K | 15.23% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $581 | $581 | 4.00% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFITS | 136 E. SOUTH TEMPLE #2300 SALT LAKE, UT 84111 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $960 | $2K | 17.53% |
| NATIONAL BENEFIT CENTER3 | 6830 CHOCHRAN ROAD SOLON, OH 44139 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $510 | $510 | 4.00% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFITS | 136 E. SOUTH TEMPLE #2300 SALT LAKE, UT 84111 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $238 | $127 | $365 | 15.31% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD. SOLON, OH 44139 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $95 | $95 | 3.98% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 SERVICE PROVIDER | Float revenue; Other services; Claims processing; Non-monetary compensation; Direct payment from the plan; Participant communication; Named fiduciary; Contract Administrator Service code 12 | — | $20K |
| CONNECTICUT GENERAL LIFE INSURANCE EIN 59-1031071 VENDOR | Other services; Participant communication; Direct payment from the plan; Claims processing; Non-monetary compensation; Float revenue; Named fiduciary; Contract Administrator Service code 12 | — | $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 | 124 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 124 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 221 | $411K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $20K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $13K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $15K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $2K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 221 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.