| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY SE STE1950 ATLANTA, GA 30339 | BLUECROSS BLUESHIELD OF ILLINOIS | — | $5K | $5K | 0.25% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PKWY SE STE1950 ATLANTA, GA 30339 | BLUECROSS BLUESHIELD OF ILLINOIS | — | $119 | $119 | 0.01% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PKWY SE STE1950 ATLANTA, GA 30339 | HARTFORD LIFE AND ACCIDENT | $0 | $7K | $7K | 4.24% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY SE STE1950 ATLANTA, GA 30339 | DEARBORN LIFE INSURANCE | $0 | $3K | $3K | 6.80% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 303395946 | VISION SERVICE PLAN | $1K | $0 | $1K | 4.84% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PWKY SW STE 1950 ATLANTA, GA 303395946 | VISION SERVICE PLAN | $1K | — | $1K | 7.78% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE | 200 GALLERIA PKWY SE STE1950 ATLANTA, GA 30339 | HARTFORD LIFE AND ACCIDENT | $500 | $100 | $600 | 19.35% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PKWY SE STE1950 ATLANTA, GA 30339 | HARTFORD LIFE AND ACCIDENT INSURANCE CO | $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 | $249K |
| DELTA DENTAL OF INDIANA EIN 35-1545647 BENEFIT ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | 16172 COLLECTIONS CENTER DRIVE CHICAGO, IL 60693 | $15K |
| DIGITAL INSURANCE LLC EIN 58-2522668 BROKER | Other commissions Service code 55 | 200 GALLERIA PKWY SE STE1950 ATLANTA, GA 303395946 | $3K |
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 | 628 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 20 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 648 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUECROSS BLUESHIELD OF ILLINOIS | 245 | $2.2M |
| Dental | BLUECROSS BLUESHIELD OF ILLINOIS | 245 | $2.1M |
| Vision(2 contracts) | VISION SERVICE PLAN | 300 | $39K |
| Life insurance(5 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 628 | $215K |
| Short-term disability | DEARBORN LIFE INSURANCE | 140 | $45K |
| Long-term disability | DEARBORN LIFE INSURANCE | 140 | $45K |
| Prescription drug | BLUECROSS BLUESHIELD OF ILLINOIS | 245 | $2.1M |
| Stop-loss / reinsurancereinsurance | BERKSHIRE HATHAWY SPECIALTY INS. CO | 250 | $395K |
| Other | DEARBORN LIFE INSURANCE | 140 | $45K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 628 | — |
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.