| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC3 | 19200 STEVENS CREEK BLVD, SUITE 110 CUPERTINO, CA 95014 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $35K | — | $35K | 9.89% |
| DIGITAL INSURANCE LLC3 | 19200 STEVENS CREEK BLVD, SUITE 110 CUPERTINO, CA 95014 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $5K | — | $5K | 9.86% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PARKWAY, SUITE 1950 ATLANTA, GA 30339 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | — | $5K | 11.22% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS GENERAL AG | 400 BERWYN PARK, SUITE 200 BERWYN, PA 193121190 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | $38 | $1K | 25.73% |
| ENROLLEASE3 Filed as: ONEDIGITAL PREMIER SERVICES | 400 BERWYN PARK, SUITE 200 BERWYN, PA 193121190 | PRINCIPAL LIFE INSURANCE COMPANY | $337 | — | $337 | 6.25% |
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 | 205 | 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) | 205 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 99 | $358K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 84 | $52K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 84 | $52K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 266 | $49K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 266 | $49K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 266 | $49K |
| Other | PRINCIPAL LIFE INSURANCE COMPANY | 32 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 266 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.