| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES | 1600 W HILLSDALE BLVD, SUITE 201 SAN MATEO, CA 94403 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $0 | $18K | $18K | 1.98% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, LLC | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 30339 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $779 | $0 | $779 | 0.09% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, LLC | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 30339 | DELTA DENTAL OF CALIFORNIA | $6K | $0 | $6K | 6.58% |
| ENTENTE ADMINISTRATORS, LLC3 | 1210 ROBBIE LANE GALLATIN, TN 37066 | DELTA DENTAL OF CALIFORNIA | $2K | $0 | $2K | 2.39% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, LLC | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 30339 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | $589 | $2K | 17.87% |
| ENTENTE ADMINISTRATORS, LLC3 | 1210 ROBBIE LANE GALLATIN, TN 37066 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $250 | $0 | $250 | 2.12% |
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 | 0 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 123 | $911K |
| Dental | DELTA DENTAL OF CALIFORNIA | 111 | $91K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 123 | $911K |
| Life insurance | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 167 | $12K |
| Other | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 167 | $12K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 167 | — |
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.