| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC | — | BLUE CROSS BLUE SHIELD OF ILLINOIS | $18K | $3K | $21K | 1.20% |
| RUSSELL L WARYE3 | — | BLUE CROSS BLUE SHIELD OF ILLINOIS | $16K | — | $16K | 0.95% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $10K | $8K | $19K | 8.81% |
| RUSSELL L WAYRE3 | 399 GROVE STREET GLENCOE, IL 60022 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 3.11% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | VISION SERVICE PLAN | $548 | — | $548 | 4.00% |
| RUSSELL L WAYRE3 | 1850 WEST WINCHESTER ROAD SUITE 103 LIBERTYVILLE, IL 60048 | VISION SERVICE PLAN | $246 | — | $246 | 1.80% |
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 | 252 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 254 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ILLINOIS | 316 | $1.7M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 245 | $213K |
| Vision | VISION SERVICE PLAN | 155 | $14K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 245 | $213K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 245 | $213K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 245 | $213K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 245 | $213K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 316 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.