| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFIT SERVI | 136 E. SOUTH TEMPLE STE 2300 SALT LAKE, UT 84111 | AMERITAS LIFE INSURANCE CORP | $4K | $955 | $5K | 2.80% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFITS | 136 E. SOUTH TEMPLE #2300 SALT LAKE, UT 84111 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | $2K | $7K | 13.32% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $2K | $2K | 4.00% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE BENEFITS | 136 E. SOUTH TMEPLE #2300 SALT LAKE CITY, UT 84111 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $695 | $3K | 12.86% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $972 | $972 | 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 | $390 | $2K | 13.15% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $494 | $494 | 4.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| REGENCE BLUECROSS BLUESHIELD OF UTA EIN 87-0200138 CLAIMS PROCESSING SERVICE | Float revenue; Claims processing; Direct payment from the plan Service code 12 | — | $185K |
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. |
| Total participants (= "Plan participants" tile) | 318 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | REGENCE BLUECROSS BLUESHIELD OF UTAH | 772 | $0 |
| Dental | AMERITAS LIFE INSURANCE CORP | 734 | $175K |
| Vision | AMERITAS LIFE INSURANCE CORP | 734 | $175K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $52K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $24K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $12K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 772 | — |
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.