| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY, SOUTHEAST SUITE 1950 ATLANTA, GA 30339 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $4K | $21K | $25K | 3.60% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SRVC(OH) | P.O. BOX 632886 CINCINNATI, OH 45263 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $2K | $12K | $14K | 2.07% |
| DIGITAL INSURANCE LLC3 | 109 WESTPARK DRIVE SUITE 200 BRENTWOOD, TN 37027 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 8.04% |
| HURWITZ III, DONALD S3 | 1600 DIVISION STREET SUITE 400 NASHVILLE, TN 37203 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 5.14% |
| DIGITAL INSURANCE LLC3 | 109 WESTPARK DRIVE SUITE 200 BRENTWOOD, TN 37027 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $882 | — | $882 | 11.01% |
| HURWITZ III, DONALD S3 | 1600 DIVISION STREET SUITE 400 NASHVILLE, TN 37203 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $390 | — | $390 | 4.87% |
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 | 159 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 6 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 168 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 118 | $684K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 118 | $684K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 118 | $684K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 141 | $91K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 141 | $83K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 141 | $83K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 141 | $91K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 141 | — |
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.
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.