| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY STE 1950 ATLANTA, GA 30339 | HARTFORD LIFE AND ACCIDENT | $110K | $8K | $118K | 8.00% |
| PALOMAR INSURANCE CORPORATION Filed as: PALOMAR INS CORP | P.O. DRAWER 11128 MONTGOMERY, AL 36111 | HARTFORD LIFE AND ACCIDENT | $86K | — | $86K | 5.84% |
| DIGITAL INSURANCE LLC Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PARKWAY SUITE 195 ATLANTA, GA 30339 | CONTINENTAL AMERICAN INSURANCE COMPANY | $79K | — | $79K | 14.91% |
| DIGITAL INSURANCE LLC Filed as: DIGITAL INSURANCE INC | 400 GALLERIA PARKWAY SUITE 300 ATLANTA, GA 30339 | CONTINENTAL AMERICAN INSURANCE COMPANY | $53K | — | $53K | 9.92% |
| PALOMAR INSURANCE CORPORATION | P.O. BOX 11128 MONTGOMERY, AL 36111 | VISION SERVICE PLAN | $8K | — | $8K | 10.00% |
| DIGITAL INSURANCE LLC Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY STE 1950 ATLANTA, GA 30339 | VISION SERVICE PLAN | $4K | — | $4K | 10.00% |
| DIGITAL INSURANCE LLC | 400 GALLERIA PKWY SE STE 300 ATLANTA, GA 30339 | AFLAC | $1K | — | $1K | 11.71% |
| SANDRA L SIEBERT Filed as: SANDRA LEE SIEBERT | 6070 TANGLETREE DRIVE ROSWELL, GA 30075 | AFLAC | $543 | — | $543 | 5.92% |
| WILLIAM DEAN THOMPSON | 1050 LENOX PARK BLVD NE APT 9201 BROOKHAVEN, GA 30319 | AFLAC | $371 | — | $371 | 4.05% |
| ANDREW DAVID KOWN | 710 CREEKGARDEN CT ATLANTA, GA 30339 | AFLAC | $305 | — | $305 | 3.33% |
| ANDREW DAVID KOWN | 6130 RIVER SHORE PKWY ATLANTA, GA 30328 | AFLAC | $215 | — | $215 | 2.35% |
| DEANNA CONN | 477 LAKE PARK LN ACWORTH, GA 30101 | AFLAC | $191 | — | $191 | 2.08% |
| DEANNA CONN | 477 SOUTHERN HILLS DR CALERA, AL 35040 | AFLAC | $77 | — | $77 | 0.84% |
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 | 1,620 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,620 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD ALABAMA | 5,183 | $7.2M |
| Dental | BLUE CROSS BLUE SHIELD ALABAMA | 5,183 | $7.2M |
| Vision(3 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD ALABAMA | 5,183 | $7.3M |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 2,955 | $1.5M |
| Short-term disability(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 2,955 | $2.0M |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 2,955 | $1.5M |
| Prescription drug | BLUE CROSS BLUE SHIELD ALABAMA | 5,183 | $7.2M |
| Other | BLUE CROSS BLUE SHIELD ALABAMA | 5,183 | $7.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,183 | — |
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."
No prospect flags tripped on this filing.