| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFITS | 136 E. SOUTH TEMPLE #2300 SALT LAKE, UT 84111 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $0 | $3K | 9.09% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $1K | $1K | 3.64% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFITS | 136 E. SOUTH TEMPLE #2300 SALT LAKE, UT 84111 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $0 | $2K | 9.10% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $791 | $791 | 3.64% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFITS | 136 E. SOUTH TEMPLE #2300 SALT LAKE, UT 84111 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $0 | $2K | 9.08% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD. SOLON, OH 44139 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $732 | $732 | 3.63% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFIT SVCS | 136 E. SOUTH TEMPLE #2300 SALT LAKE CITY, UT 84111 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $288 | $0 | $288 | 9.05% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $115 | $115 | 3.62% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $236K |
| DIVERSIFIED INSURANCE BENEFIT SERVI BROKER | Other commissions Service code 55 | 136 E SOUTH TEMPLE #2300 SALT LAKE CITY, UT 84111 | $89K |
| CIGNA HEALTH & LIFE INS CO | Named fiduciary; Other services; Claims processing; Direct payment from the plan; Non-monetary compensation; Participant communication; Float revenue; 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 | 225 | 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) | 225 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $20K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $22K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | TOKIO MARINE | 225 | $926K |
| Other(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $40K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 225 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.