| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ENROLLEASE3 Filed as: ONE DIGITAL - DOWNERS GROVE, IL | 200 GALLERIA PARKWAY, STE. 1950 ATLANTA, GA 30339 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | $0 | $2K | 8.21% |
| ENROLLEASE3 Filed as: ONE DIGITAL - DOWNERS GROVE, IL | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 30339 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $1K | $0 | $1K | 8.20% |
| ENROLLEASE3 Filed as: ONE DIGITAL - DOWNERS GROVE, IL | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 30339 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $94 | $0 | $94 | 4.82% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITEDHEALTHCARE EIN 41-1321939 NONE | Claims processing Service code 12 | — | $70K |
| DELTA DENTAL OF WI EIN 39-6094742 NONE | Claims processing Service code 12 | — | $12K |
| EXPRESS SCRIPTS EIN 22-3461740 NONE | Claims processing Service code 12 | — | $12K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 657 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 657 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. | 798 | $654K |
| Vision(4 contracts) | FIDELITY SECURITY LIFE INSURANCE COMPANY | 301 | $38K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 798 | — |
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.