| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| REFINED BENEFITS DBA SULLIVAN3 Filed as: REFINED BENEFIT DBA SULLIVAN | 10672 BLOOMINGDALE AVENUE SUITE 102 RIVERVIEW, FL 33578 | SUN LIFE ASSURANCE COMPANY OF CANADA | $34K | — | $34K | 8.30% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE | 200 GALLERIA PARKWAY ST. SUITE 1950 ATLANTA, GA 303395946 | SUN LIFE ASSURANCE COMPANY OF CANADA | $7K | — | $7K | 1.70% |
| REFINED BENEFITS DBA SULLIVAN3 Filed as: REFINED BENEFITS | 10672 BLOOMINGTON AVE SUITE 102 RIVERVIEW, FL 33578 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $14K | $3K | $17K | 17.51% |
| SEE ATTACHED3 Filed as: SEE ATTACHED LISTING | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $8K | $192 | $9K | 25.93% |
| DIGITAL INSURANCE LLC3 | 1105 NIKKI VIEW DR BRANDON, LA 33511 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 4.39% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY ST. SUITE 1950 ATLANTA, GA 303395946 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $245 | — | $245 | 0.88% |
| DAVIS II COMPANIES LLC3 | 4200 W CYPRESS STREET #700 TAMPA, FL 33607 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $47 | — | $47 | 0.17% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MERITAIN HEALTH EIN 16-1264154 CLAIMS PROCESSING, UR, | Claims processing Service code 12 | P.O. BOX 27267 MINNEAPOLIS, MN 554270267 | $142K |
| REFINED BENEFITS DBA SULLIVAN BROKER | Insurance agents and brokers Service code 22 | 10672 BLOOMINGTON AVENUE SUITE 102 RIVERVIEW, FL 33578 | $40K |
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 | 277 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 278 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | AFLAC | 267 | $61K |
| Vision | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 267 | $28K |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 264 | $128K |
| Short-term disability | AFLAC | 46 | $33K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 238 | $404K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 264 | $128K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 267 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.