| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, LLC | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $896 | $896 | 0.34% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $8K | $4K | $12K | 10.89% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN | 11330 LAKEFIELD DRIVE SUITE 100 DULUTH, GA 30097 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 2.49% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CLAIMS ADMIN | Plan Administrator; Contract Administrator; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $28K |
| DIGITAL INSURANCE LLC BROKER | Insurance agents and brokers; Insurance services Service code 22 | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | $27K |
| MARSH AND MCLENNAN AGENCY BROKER | Insurance services; Insurance agents and brokers Service code 22 | 11330 LAKEFILED DRIVE SUITE 100 DULUTH, GA 30097 | $9K |
| CIGNA | Participant communication; Named fiduciary; Non-monetary compensation; Direct payment from the plan; Float revenue; Other services; Claims processing; Contract Administrator Service code 12 | — | $0 |
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 | 153 | 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) | 153 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 153 | $264K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 153 | $264K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 153 | $264K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 192 | $110K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 192 | $110K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 192 | $110K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 192 | $110K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 192 | — |
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.