| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY SUITE 1950 ATLANTA, GA 30339 | BOSTON MUTUAL LIFE INSURANCE COMPANY | $1K | $0 | $1K | 14.66% |
| LYONS INSURANCE AGENCY INC3 Filed as: LYONS INSURANCE AGENCY - BOR | 501 CARR RD #301 WILMINGTON, DE 19803 | EYEMED VISION CARE | $539 | $0 | $539 | 10.06% |
| LYONS INSURANCE AGENCY INC3 Filed as: LYONS INSURANCE AGENCY, INC. | 501 CARR RD STE 301 WILMINGTON, DE 19809 | DEARBORN LIFE INSURANCE COMPANY | $1K | $0 | $1K | 25.01% |
| SUSAN M DAHMS3 | 18 COACH HILL COURT NEWARK, DE 19711 | DEARBORN LIFE INSURANCE COMPANY | $0 | $484 | $484 | 9.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HIGHMARK OF DELAWARE EIN 51-0020405 ADMIN | Claims processing Service code 12 | — | $14K |
| LYONS COMPANIES EIN 51-0276731 BROKER | Insurance agents and brokers Service code 22 | — | $12K |
| THE BENECON GROUP, LLC EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $11K |
| CONNECTCARE 3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $2K |
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 | 37 | 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) | 37 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | HIGHMARK OF DELAWARE | 69 | $29K |
| Vision | EYEMED VISION CARE | 65 | $5K |
| Life insurance | BOSTON MUTUAL LIFE INSURANCE COMPANY | 93 | $9K |
| Short-term disability | DEARBORN LIFE INSURANCE COMPANY | 13 | $5K |
| Stop-loss / reinsurancereinsurance | HM LIFE INSURANCE COMPANY | 37 | $353K |
| Other | BOSTON MUTUAL LIFE INSURANCE COMPANY | 93 | $9K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 93 | — |
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.