| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE | 200 GALLERIA PARKWAY, SUITE 1950 ATLANTA, GA 30339 | KAISER FOUNDATION HEALTH PLAN INC. | $31K | — | $31K | 5.01% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 2267 LAVA RIDGE COURT, SUITE 200 ROSEVILLE, CA 95661 | WESTERN HEALTH ADVANTAGE | $8K | — | $8K | 5.00% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 200 GALLERIA PARKWAY, SUITE 1950 ATLANTA, GA 30339 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $9K | $6K | $15K | 10.27% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | ANTHEM BLUE CROSS | $3K | — | $3K | 6.85% |
| LISA INC.3 | 1600 WEST HILLSDALE BLVD. SAN MATEO, CA 94402 | ANTHEM BLUE CROSS | — | $1K | $1K | 3.42% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | ANTHEM BLUE CROSS | $539 | — | $539 | 7.10% |
| AMWINS3 Filed as: LISI INC. | 1600 W. HILLSDALE BLVD. SAN MATEO, CA 94403 | ANTHEM BLUE CROSS | — | $270 | $270 | 3.56% |
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 | 173 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 173 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 143 | $819K |
| Dental(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 173 | $155K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 173 | $147K |
| Prescription drug(4 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 143 | $819K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 173 | $147K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 173 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.