| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 303395946 | BLUE CROSS BLUE SHIELD OF ILLINOIS | $45K | $2K | $47K | 4.38% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 303395946 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $226 | $2K | 20.43% |
| SHELTON BENEFITS LLC3 Filed as: SHELTON ADVISORS INC. | 939 W NORTH AVENUE SUITE 750 CHICAGO, IL 60642 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $565 | — | $565 | 6.01% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 303395946 | DEARBORN LIFE INSURANCE COMPANY | $925 | $553 | $1K | 15.94% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 303395946 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $165 | $2K | 26.53% |
| SHELTON BENEFITS LLC3 Filed as: SHELTON ADVISORS INC. | 939 W NORTH AVENUE SUITE 750 CHICAGO, IL 60642 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $412 | — | $412 | 6.03% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 303395946 | TRANSAMERICA LIFE INSURANCE COMPANY | $651 | — | $651 | 23.03% |
| JAMES T KINNEY3 | 1429 WARWICK AVENUE WARWICK, RI 02888 | TRANSAMERICA LIFE INSURANCE COMPANY | $28 | — | $28 | 0.99% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 303395946 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $354 | $39 | $393 | 20.38% |
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 | 100 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 101 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ILLINOIS | 158 | $1.1M |
| Dental | BLUE CROSS BLUE SHIELD OF ILLINOIS | 158 | $1.1M |
| Vision | DEARBORN LIFE INSURANCE COMPANY | 56 | $9K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 100 | $16K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 8 | $2K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 100 | $9K |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 100 | $19K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 158 | — |
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.