| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PARKWAY STE 1950 ATLANTA, GA 30339 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $49K | — | $49K | 3.20% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PARKWAY STE 1950 ATLANTA, GA 30339 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $482 | — | $482 | 0.03% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PKWY STE 1950 ATLANTA, GA 30339 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $5K | — | $5K | 4.00% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PKWY STE 1950 ATLANTA, GA 30339 | FIRST UNUM LIFE INSURANCE COMPANY | $3K | $842 | $4K | 11.44% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PKWY STE 1950 ATLANTA, GA 30339 | FIRST UNUM LIFE INSURANCE COMPANY | $4K | $566 | $5K | 17.77% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PKWY STE 1950 ATLANTA, GA 30339 | FIRST UNUM LIFE INSURANCE COMPANY | $2K | $298 | $3K | 17.00% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PKWY STE 1950 ATLANTA, GA 30339 | FIRST UNUM LIFE INSURANCE COMPANY | $597 | $80 | $677 | 21.34% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH, PA | $165 | — | $165 | 15.04% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PKWY STE 1950 ATLANTA, GA 30339 | FIRST UNUM LIFE INSURANCE COMPANY | $46 | $9 | $55 | 11.75% |
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 | 118 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 121 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 247 | $1.5M |
| Dental | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 105 | $127K |
| Vision | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 247 | $1.5M |
| Life insurance(2 contracts) | FIRST UNUM LIFE INSURANCE COMPANY | 114 | $61K |
| Short-term disability(3 contracts) | FIRST UNUM LIFE INSURANCE COMPANY | 114 | $38K |
| Long-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 66 | $15K |
| Other(5 contracts, 2 carriers) | FIRST UNUM LIFE INSURANCE COMPANY | 122 | $80K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 247 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.