| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SE1 SUITE 1950 ATLANTA, GA 30339 | BLUE CROSS BLUE SHIELD OF MINNESOTA | — | $4K | $4K | 1.96% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY STE 1950 ATLANTA, GA 30339 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $6K | $5K | $11K | 14.76% |
| MELODIE GALE3 | 16703 RIVER ROAD NORTH BRANCH, MN 55056 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $4K | $4K | 4.66% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY STE 1950 ATLANTA, GA 30339 | THE HARTFORD | $5K | — | $5K | 7.07% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PARKWAY STE 1950 ATLANTA, GA 30339 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 6.66% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BCBSMN DBA BCBS OF MINNESOTA EIN 41-0984460 CONTRACT ADMINISTRATOR | Contract Administrator; Legal; Claims processing; Other fees; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | P.O. BOX 64560 ST. PAUL, MN 551640560 | $187K |
| BCBSMN | Other fees; Contract Administrator; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $80K |
| RELIANCE STANDARD LIFE INS. CO. EIN 36-0883760 CONTRACT ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | PO BOX 82510 LINCOLN, NE 68501 | $13K |
| BCBCMN | Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 12 | — | $2K |
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 | 271 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 277 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MINNESOTA | 483 | $195K |
| Vision | RELIANCE STANDARD LIFE INSURANCE COMPANY | 365 | $35K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 271 | $77K |
| Long-term disability | THE HARTFORD | 265 | $65K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MINNESOTA | 483 | $195K |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 271 | $77K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 483 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.