| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PARKWAY STE. 1950 ATLANTA, GA 30339 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $40K | $11K | $51K | 10.13% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PARKWAY STE. 1950 ATLANTA, NC 30339 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $20K | $5K | $26K | 12.57% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PARKWAY STE. 1950 ATLANTA, GA 30339 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $2K | $2K | 1.96% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PARKWAY STE. 1950 ATLANTA, GA 30339 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $4K | — | $4K | 4.59% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PARKWAY STE. 1950 ATLANTA, GA 30339 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $871 | $5K | 9.67% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PARKWAY STE. 1950 ATLANTA, GA 30339 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $254 | $254 | 2.20% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PARKWAY STE. 1950 ATLANTA, GA 30339 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $887 | $230 | $1K | 10.08% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX INC EIN 33-0441200 PHARMACY BENEFIT MANAGEME | Claims processing; Other fees; Direct payment from the plan; Float revenue Service code 12 | PO BOX 650629 DALLAS, TX 75265 | $3.1M |
| UMR INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | PO BOX 30541 SALT LAKE CITY, UT 84130 | $302K |
| CIGNA HEALTH AND LIVE INSURANCE CO EIN 59-1031071 | Direct payment from the plan; Contract Administrator; Claims processing; Named fiduciary; Float revenue; Non-monetary compensation; Other services; Participant communication Service code 12 | 900 COTTAGE GROVE ROAD BLOOMFIELD, CT 06002 | $40K |
| DEEPVIEW SOLUTIONS INC BROKER | Other commissions Service code 55 | 4348 SOUTHPOINT BLVD STE 400 JACKSONVILLE, FL 32216 | $16K |
| ONEDIGITAL EIN 58-2522668 BROKER | Other commissions Service code 55 | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 303395946 | $7K |
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 | 730 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 730 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,224 | $81K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 535 | $52K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 457 | $205K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 399 | $502K |
| Stop-loss / reinsurancereinsurance | SWISS RE CORPORATE SOLUTIONS | 708 | $324K |
| Other(3 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 537 | $139K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,224 | — |
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.