| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STHEALTH BENEFIT SOLUTIONS LLC3 | 18940 NORTH PIMA ROAD #210 SCOTTSDALE, AZ 85255 | UNIMERICA INSURANCE COMPANY | $16K | $0 | $16K | 7.00% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY, STE 1950 ATLANTA, GA 30339 | DEARBORN NATIONAL | $8K | $4K | $12K | 20.87% |
| IBSI HOLDINGS INC3 | PO BOX 24337 WINSTON SALEM, NC 271144337 | DEARBORN NATIONAL | $0 | $3K | $3K | 5.00% |
| GROUP BENEFIT SOLUTIONS3 | 580 DAVIDSON GATEWAY DRIVE DAVIDSON, NC 28036 | DEARBORN NATIONAL | $727 | $0 | $727 | 1.23% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PARKWAY, STE. 1950 ATLANTA, GA 30339 | STANDARD INSURANCE COMPANY | $5K | $0 | $5K | 9.73% |
| IBSI HOLDINGS INC3 Filed as: IBSI HOLDING INC | 1381 OLD MILL CIRCLE #301 WINSTOM SALEM, NC 27103 | STANDARD INSURANCE COMPANY | $3K | $0 | $3K | 5.15% |
| GROUP BENEFIT SOLUTIONS3 | 580 DAVIDSON GATEWAY DR DAVIDSON, NC 28036 | STANDARD INSURANCE COMPANY | $436 | $0 | $436 | 0.82% |
| ENROLLEASE3 Filed as: DIGITAL BENEFIT ADVISOR - RALEIGH | 200 GALLERIA PARKWAY, STE. 1950 ATLANTA, GA 30339 | EYEMED | $578 | — | $578 | 7.58% |
| IBSI HOLDINGS INC3 Filed as: IBSI BROKERS | PO BOX 24337 WINSTOM SALEM, NC 27114 | EYEMED | $0 | $384 | $384 | 5.04% |
| GROUP BENEFIT SOLUTIONS3 | 580 DAVIDSON GATEWAY DR DAVIDSON, NC 28036 | EYEMED | $123 | — | $123 | 1.61% |
| ENROLLEASE3 Filed as: DIGITAL INSURANCE - RALEIGH, NC | 200 GALLERIA PARKWAY, STE. 1950 ATLANTA, GA 30339 | EYEMED | $66 | — | $66 | 0.87% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CORESOURCE, INC EIN 35-1846036 NONE | Claims processing; Plan Administrator; Other services Service code 12 | 2105 WATER RIDGE PARKWAY CHARLOTTE, NC 28217 | $48K |
| DIGITAL INSURANCE, INC EIN 58-2522668 NONE | Insurance agents and brokers; Consulting (general) Service code 16 | 200 GALLERIA PKWY STE 1950 ATLANTA, GA 30339 | $31K |
| CIGNA PPO EIN 59-1031071 NONE | Other services; Claims processing Service code 12 | 900 COTTAGE GROVE RD BLOOM FIELD, CT 06002 | $17K |
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 | 100 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 100 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | STANDARD INSURANCE COMPANY | 100 | $53K |
| Vision | EYEMED | 157 | $8K |
| Life insurance | DEARBORN NATIONAL | 129 | $59K |
| Short-term disability | DEARBORN NATIONAL | 129 | $59K |
| Long-term disability | DEARBORN NATIONAL | 129 | $59K |
| Stop-loss / reinsurancereinsurance | UNIMERICA INSURANCE COMPANY | 100 | $233K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 157 | — |
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.