| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFIT SERVI | 136 EAST SOUTH TEMPLE #2300 SALT LAKE CITY, UT 84111 | LIFEMAP ASSURANCE COMPANY | $24K | $0 | $24K | 11.61% |
| MERCER HEALTH AND BENEFITS, LLC3 | 15 W S TEMPLE STE 700 SALT LAKE CITY, UT 84101 | LIFEMAP ASSURANCE COMPANY | $0 | $0 | $0 | 0.00% |
| MERCER HEALTH AND BENEFITS, LLC3 | 155 N WACKER DR STE 1500 CHICAGO, IL 60606 | KAISER FOUNDATION HEALTH PLAN INC. | $4K | $0 | $4K | 6.82% |
| DIVERSIFIED INSURANCE GROUP3 | 136 E SOUTH TEMPLE STE 2300 SALT LAKE CITY, UT 84111 | KAISER FOUNDATION HEALTH PLAN INC. | $3K | $0 | $3K | 5.05% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $39K | $0 | $39K | 76.02% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFIT SVCS | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $5K | $0 | $5K | 9.93% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INS BENEFIT SERVICES | 136 E SOUTH TEMPLE STE 2300 SALT LAKE, UT 84111 | METROPOLITAN PROPERTY AND CASUALTY INSURANCE CO. | $1K | $0 | $1K | 10.00% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | METROPOLITAN PROPERTY AND CASUALTY INSURANCE CO. | $34 | $95 | $129 | 0.87% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE EIN 41-1289245 CLAIMS PROCESSOR | Other services; Claims processing Service code 12 | — | $265K |
| MERCER HEALTH & BENEFITS EIN 34-2015463 BROKER | Other commissions Service code 55 | — | $147K |
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 | 318 | 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) | 318 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 9 | $65K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 957 | $52K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 957 | $52K |
| Life insurance | LIFEMAP ASSURANCE COMPANY | 318 | $206K |
| Short-term disability | LIFEMAP ASSURANCE COMPANY | 318 | $206K |
| Long-term disability | LIFEMAP ASSURANCE COMPANY | 318 | $206K |
| Stop-loss / reinsurancereinsurance | UNITED HEALTHCARE INSURANCE COMPANY | 919 | $763K |
| Other(2 contracts, 2 carriers) | LIFEMAP ASSURANCE COMPANY | 318 | $221K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 957 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.