| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PARKWAY ST. SUITE 1950 ATLANTA, GA 303395946 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $27K | — | $27K | 10.00% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 200 GALLERIA PARKWAY ST. SUITE 1950 ATLANTA, GA 303395946 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $14K | — | $14K | 10.00% |
| REFINED BENEFITS DBA SULLIVAN3 Filed as: REFINED BENEFITS INC DBA SULLIVAN | 10672 BLOOMINGDALE AVE SUITE 102 RIVERVIEW, FL 33578 | VISION SERVICE PLAN | $10K | — | $10K | 9.18% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 200 GALLERIA PARKWAY ST. SUITE 1950 ATLANTA, GA 303395946 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | — | $8K | 10.00% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 200 GALLERIA PARKWAY ST. SUITE 1950 ATLANTA, GA 303395946 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 10.00% |
| JOSEPH SULLIVAN3 | 1105 NIKKI VIEW DRIVE BRANDON, FL 33511 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $290 | — | $290 | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $315K |
| AETNA BEHAVIORAL HEALTH, LLC EIN 20-0446713 EAP PLAN ADMINISTRATOR | Plan Administrator Service code 14 | — | $12K |
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 | 699 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 704 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 672 | $104K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 699 | $143K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 699 | $269K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 699 | $80K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 617 | $840K |
| Other(5 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 699 | $163K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 699 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.