| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| REFINED BENEFITS DBA SULLIVAN3 | 1105 NIKKI VIEW DR BRANDON, FL 33511 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $30K | — | $30K | 10.13% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 30339 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $10K | — | $10K | 3.29% |
| DIGITAL INSURANCE LLC3 | 1105 NIKKI VIEW DR BRANDON, FL 33511 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $7K | $3K | $10K | 11.01% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $753 | $3K | 3.35% |
| DAVIS II COMPANIES LLC3 | 5426 BAY CENTER DR SUITE 550 TAMPA, FL 336093406 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $24 | — | $24 | 0.03% |
| REFINED BENEFITS DBA SULLIVAN3 Filed as: REFINED BENEFITS | 10672 BLOOMINGTON AVE STE 102 RIVERVIEW, FL 33578 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 18.66% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 30339 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $585 | — | $585 | 2.44% |
| REFINED BENEFITS DBA SULLIVAN3 Filed as: REFINED BENEFITS | 10672 BLOOMINGTON AVE STE 102 RIVERVIEW, FL 33578 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $899 | $3K | 17.37% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 30339 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $456 | — | $456 | 2.44% |
| REFINED BENEFITS DBA SULLIVAN3 | 10672 BLOOMINGDALE AVE SUITE 102 RIVERVIEW, FL 33578 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $733 | — | $733 | 6.44% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $405 | — | $405 | 3.56% |
| REFINED BENEFITS DBA SULLIVAN3 Filed as: REFINED BENEFITS | 10672 BLOOMINGTON AVE STE 102 RIVERVIEW, FL 33578 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $533 | $212 | $745 | 16.89% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 30339 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $108 | — | $108 | 2.45% |
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 | 230 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 235 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 179 | $294K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 170 | $90K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 137 | $11K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 230 | $28K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 60 | $19K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 230 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 230 | — |
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.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.