| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFIT SERV | 136 E SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 84117 | SELECTHEALTH | $81K | $27K | $108K | 3.70% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BNFT SVS | 136 E SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 84111 | SELETHEALTH | $4K | $1K | $6K | 3.99% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFITS SERV | 136 E SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 84111 | PRINCIPAL LIFE INSURANCE COMPANY | $12K | — | $12K | 8.44% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BNFT SVS | 136 E SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 84111 | SELECTHEALTH | $3K | $1K | $5K | 3.97% |
| DIVERSIFIED INSURANCE GROUP3 | 136 E SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 84117 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $3K | — | $3K | 10.00% |
| DIVERSIFIED INSURANCE3 | 136 E SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 84117 | SELECT BENEFITS GROUP INC., DBA DENTAL SELECT | $7K | — | $7K | — |
No Schedule C service providers reported on this filing.
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 | 352 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 352 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | SELECTHEALTH | 2,035 | $3.2M |
| Dental | SELECT BENEFITS GROUP INC., DBA DENTAL SELECT | 229 | $0 |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 163 | $32K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 1,084 | $146K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 1,084 | $146K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,035 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.