| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC3 | 8235 FORSYTH BLVD SUITE 1200 SAINT LOUIS, MO 63105 | BLUECROSS BLUESHIELD OF ILLINOIS | $0 | $4K | $4K | 0.18% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PKWY STE 1950 ATLANTA, GA 30339 | HARTFORD LIFE AND ACCIDENT | $0 | $724 | $724 | 0.44% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PKWY STE 1950 ATLANTA, GA 30339 | HARTFORD LIFE AND ACCIDENT | $0 | $0 | $0 | 0.00% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY STE 1950 ATLANTA, GA 30339 | DEARBORN LIFE INSURANCE COMPANY | $0 | $2K | $2K | 4.23% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY SE SUITE 1950 ATLANTA, GA 303395946 | VISION SERVICE PLAN | $2K | — | $2K | 8.76% |
| DIGITAL INSURANCE LLC3 | 8235 FORSYTH BLVD SUITE 1200 SAINT LOUIS, MO 63105 | HARTFORD LIFE AND ACCIDENT CO | $0 | $0 | $0 | 0.00% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PKWY STE 1950 ATLANTA, GA 30339 | HARTFORD LIFE AND ACCIDENT | $501 | $16 | $517 | 15.47% |
| DIGITAL INSURANCE LLC3 | 8235 FORSYTH BLVD #1200 ST. LOUIS, MO 63101 | HARTFORD LIFE AND ACCIDENT | $0 | $0 | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES INC EIN 41-1289245 CLAIMS PROCESSOR | Claims processing; Other services Service code 12 | PO BOX 94017 PALATINE, IL 60094 | $292K |
| DELTA DENTAL OF INDIANA EIN 35-1545647 BENEFIT ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | 16172 COLLECTIONS CENTER DRIVE CHICAGO, IL 60693 | $15K |
| DIGITAL INSURANCE INC EIN 58-2522668 BROKER | Other commissions Service code 55 | 200 GALLERIA PKWY SE 1950 ATLANTA, GA 30339 | $1K |
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 | 663 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 28 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 691 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUECROSS BLUESHIELD OF ILLINOIS | 283 | $2.4M |
| Dental | BLUECROSS BLUESHIELD OF ILLINOIS | 283 | $2.4M |
| Vision(2 contracts) | VISION SERVICE PLAN | 301 | $32K |
| Life insurance(5 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 663 | $222K |
| Short-term disability | DEARBORN LIFE INSURANCE COMPANY | 135 | $42K |
| Long-term disability | DEARBORN LIFE INSURANCE COMPANY | 135 | $42K |
| Prescription drug | BLUECROSS BLUESHIELD OF ILLINOIS | 283 | $2.4M |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 264 | $298K |
| Other | DEARBORN LIFE INSURANCE COMPANY | 135 | $42K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 663 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.