| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY STE 1950 ATLANTA, GA 30339 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $279 | $8K | 15.52% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY STE 1950 ATLANTA, GA 30339 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $294 | $4K | 16.15% |
| ADP INC3 Filed as: AUTOMATIC DATA PROCESSING | PO BOX 842875 BOSTON, MA 02284 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $500 | $500 | 1.96% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY STE 1950 ATLANTA, GA 30339 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $166 | $2K | 16.16% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY STE 1950 ATLANTA, GA 30339 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $875 | $94 | $969 | 11.07% |
| ADP INC3 Filed as: AUTOMATIC DATA PROCESSING | PO BOX 842875 BOSTON, MA 02284 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $2K | $2K | 28.76% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY STE 1950 ATLANTA, GA 30339 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $782 | $65 | $847 | 16.24% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DIGITAL INSURANCE LLC BROKER | Insurance agents and brokers Service code 22 | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 30339 | $39K |
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 ADMIN | Claims processing Service code 12 | — | $3K |
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 | 128 | 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) | 128 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 114 | $330K |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 76 | $53K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 69 | $9K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 24 | $14K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 128 | $26K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 10 | $5K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 24 | $19K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 128 | — |
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.