| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY SE, STE 1950 ATLANTA, GA 30339 | UNITEDHEALTHCARE INSURANCE COMPANY | $5K | $20K | $26K | 0.47% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PKWY, STE 1950 ATLANTA, GA 30339 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $10K | $10K | 6.09% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PKWY, STE 1950 ATLANTA, GA 30339 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $3K | $3K | 5.46% |
| CLJM LLC DBA HM BENEFITS3 Filed as: CLJM, LLC DBA HM BENEFITS | 8235 FORSYTH BLVD, STE 1200 CLAYTON, MO 63105 | HERITAGE VISION PLANS INC | $3K | — | $3K | 9.97% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PKWY, STE 1950 ATLANTA, GA 30339 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $1K | $1K | 6.48% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PKWY, STE 1950 ATLANTA, GA 30339 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $68 | $68 | 9.48% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PAYLOCITY CORPORATION EIN 36-4227403 THIRD PARTY ADMINISTRATO | Contract Administrator Service code 13 | 1400 AMERICAN LANE SCHAUMBURG, IL 60173 | $12K |
| RELIANCE STANDARD LIFE INS CO EIN 36-0883760 CLAIMS ADMINISTRATOR | Claims processing Service code 12 | — | $805 |
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 | 396 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 15 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 411 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 865 | $5.5M |
| Vision | HERITAGE VISION PLANS INC | 541 | $35K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 564 | $163K |
| Long-term disability(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 291 | $73K |
| Other(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 564 | $163K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 865 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.