| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 30339 | BLUE CROSS BLUE SHIELD OF ILLINOIS | $19K | $4K | $23K | 0.56% |
| ACRISURE LLC3 | 42965 US-19 ALT PALM HARBOR, FL 34683 | BLUE CROSS BLUE SHIELD OF ILLINOIS | $4K | — | $4K | 0.10% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PKWY, SUITE 1950 ATLANTA, GA 30339 | SUN LIFE ASSURANCE COMPANY OF CANADA | $53K | — | $53K | 11.46% |
| ACRISURE LLC3 | 9500 S DADELAND BLVD, SUITE 400 MIAMI, FL 33156 | SUN LIFE ASSURANCE COMPANY OF CANADA | $31K | — | $31K | 6.64% |
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MO 49546 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $7K | $7K | 1.47% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PKWY SUITE 1950 ATLANTA, GA 30339 | RELIASTAR LIFE INSURANCE COMPANY | $21K | — | $21K | 9.03% |
| ACRISURE LLC3 | 2965 US-19 ALT PALM HARBOR, FL 34683 | RELIASTAR LIFE INSURANCE COMPANY | $14K | — | $14K | 5.97% |
| STHEALTH BENEFIT SOLUTIONS LLC3 | ATTN JILL K SHULMAN 18940 N PIMA RD STE 210 SCOTTSDALE, AZ 85255 | RELIASTAR LIFE INSURANCE COMPANY | $5K | $5K | $10K | 4.38% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CLAIM ADMINISTRATION | Contract Administrator; Direct payment from the plan; Non-monetary compensation; Named fiduciary; Participant communication; Float revenue; Claims processing; Other services Service code 12 | — | $29K |
| CIGNA | Float revenue; Other services; Named fiduciary; Participant communication; Claims processing; Direct payment from the plan; Real estate brokerage; Non-monetary compensation; Contract Administrator Service code 12 | — | $0 |
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 | 175 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 136 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 312 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ILLINOIS | 598 | $4.1M |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 277 | $461K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 277 | $461K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 277 | $461K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ILLINOIS | 598 | $4.1M |
| Stop-loss / reinsurancereinsurance | RELIASTAR LIFE INSURANCE COMPANY | 299 | $228K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 277 | $461K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 598 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.