| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE | 200 GALLARIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $30K | $5K | $35K | 2.68% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE | 200 GALLARIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $4K | — | $4K | 3.86% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE | 200 GALLARIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $2K | $5K | 11.38% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE | 200 GALLARIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $1K | $5K | 17.59% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE | 200 GALLARIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | VISION SERVICE PLAN | $857 | — | $857 | 6.11% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $908 | $472 | $1K | 15.19% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $633 | $220 | $853 | 20.23% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $544 | $109 | $653 | 18.01% |
| SHERBLOM INSURANCE AGENCY3 | 199 PARK LANE CONCORD, MA 01742 | FEDERAL INSURANCE COMPANY | $450 | — | $450 | 45.00% |
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 | 121 | 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) | 121 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 269 | $1.3M |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 306 | $112K |
| Vision | VISION SERVICE PLAN | 81 | $14K |
| Life insurance(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 121 | $55K |
| Short-term disability(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 29 | $8K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 121 | $27K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 269 | $1.3M |
| Other(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 121 | $47K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 306 | — |
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.