| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PRODUCER PARTNERS INC3 | 175 SCOTT SWAMP RD FARMINGTON, CT 06032 | SYMETRA LIFE INSURANCE COMPANY | — | $11K | $11K | 2.00% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 30339 | DELTA DENTAL OF NJ INC | $2K | — | $2K | 1.27% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 303395946 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | $12K | $21K | 32.73% |
| ENROLLEASE3 Filed as: DIGITAL INSURANCE INC ATTN ACCT MGT | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 30339 | EYEMED | $3K | — | $3K | 10.00% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PARKWAY STE 1950 ATLANTA, GA 30339 | MUTUAL OF OMAHA INSURANCE COMPANY | $128 | — | $128 | 14.97% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CONNECTICARE INC EIN 06-1618303 HLTH ASO CARRIER | Claims processing; Contract Administrator Service code 12 | 175 SCOTT SWAMP RD FARMINGTON, CT 06032 | $600K |
| DIGITAL INSURANCE INC BROKER | Insurance agents and brokers Service code 22 | 400 GALLERIA PARKWAY SE STE 300 ATLANTA, GA 303395946 | $85K |
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 | 219 | 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) | 219 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF NJ INC | 192 | $180K |
| Vision | EYEMED | 414 | $29K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 219 | $63K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 219 | $63K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 219 | $63K |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 188 | $526K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 219 | $64K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 414 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.