| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIVERSIFIED INSURANCE3 | 136 E SOUTH TEMPLE #2300 SALT LAKE, UT 84111 | COMPANION LIFE INS. CO. GROUP DENTAL INDEMNITY PLAN | $7K | — | $7K | 5.30% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INS BENEFIT SVCS | 136 EAST SOUTH TEMPLE SUITE 2300 SALT LAKE CITY, UT 84111 | HARTFORD LIFE AND ACCIDENT | $7K | — | $7K | 9.35% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFIT SERVI | 136 E. S. TEMPLE #2300 SALT LAKE CITY, UT 84111 | AMERITAS LIFE INSURANCE CORP | $3K | $147 | $3K | 10.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES INC. EIN 41-1289245 CLAIMS PROCESSOR | Claims processing; Other services Service code 12 | — | $409K |
| CIGNA BEHAVIORAL HEALTH, INC. EIN 41-1648670 ADMINISTRATOR | Contract Administrator; Direct payment from the plan; Claims processing; Participant communication Service code 12 | — | $16K |
| CIGNA BEHAVIORAL HEALTH, INC | Contract Administrator; Claims processing; Participant communication; Direct payment from the plan Service code 12 | — | $0 |
| DIVERSIFIED INSURANCE GROUP EIN 20-4442550 BROKER | Other commissions Service code 55 | — | $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 | 801 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 801 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | COMPANION LIFE INS. CO. GROUP DENTAL INDEMNITY PLAN | 542 | $133K |
| Vision | AMERITAS LIFE INSURANCE CORP | 239 | $28K |
| Life insurance(2 contracts, 2 carriers) | GERBER LIFE INSURANCE COMPANY | 801 | $581K |
| Other | HARTFORD LIFE AND ACCIDENT | 801 | $72K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 801 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.