| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERITAIN HEALTH3 | 1405 XENIUM LANE NORTH, SUITE 140 MINNEAPOLIS, MN 55441 | HCC LIFE INSURANCE COMPANY | $4K | — | $4K | 0.84% |
| CORPORATE HEALTH SYSTEMS INC3 Filed as: CORPORATE HEALTH SYSTEMS, INC. | 15153 TECHNOLOGY DRIVE, SUITE B EDEN PRAIRIE, MN 553442221 | RELIASTAR LIFE INSURANCE COMPANY | $26K | — | $26K | 13.45% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 200 GALLERIA PARKWAY STE 1950 ATLANTA, GA 30339 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 13.91% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PARKWAY, STE 1950 ATLANTA, GA 30339 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 15.00% |
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 | 762 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 762 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HCC LIFE INSURANCE COMPANY | 762 | $685K |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 762 | $190K |
| Long-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 127 | $32K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | HCC LIFE INSURANCE COMPANY | 762 | $685K |
| Other | RELIASTAR LIFE INSURANCE COMPANY | 762 | $190K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 762 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.