| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| REFINED BENEFITS DBA SULLIVAN3 Filed as: REFINED BENEFITS INC DBA SULLIVAN | 10672 BLOOMINGDALE AVE STE 102 RIVERVIEW, FL 33578 | SUN LIFE ASSURANCE COMPANY OF CANADA | $100K | $30K | $129K | 10.77% |
| DIGITAL INSURANCE LLC3 | 720 OLD SNELLVILLE HWY STE 200 LAWRENCEVILLE, GA 30044 | SUN LIFE ASSURANCE COMPANY OF CANADA | $19K | — | $19K | 1.60% |
| DIGITAL INSURANCE LLC3 | 1105 NIKKI VIEW DR BRANDON, FL 33511 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $35K | $9K | $44K | 10.43% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 1.67% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $926 | $6K | 5.50% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $16K | $807 | $17K | 17.03% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $644 | $4K | 5.74% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $359 | $8K | 17.18% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 15.28% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MERITAIN HEALTH EIN 16-1264154 CLAIMS ADMINISTRATOR | Claims processing Service code 12 | — | $176K |
| REFINED BENEFITS EIN 59-3652048 INS BROKER | Other commissions Service code 55 | DBA SULLIVAN BENEFITS 10672 BLOOMINGDALE AVE SUITE 102 RIVERVIEW, FL 33578 | $164K |
| MEDCOM BENEFIT SOLUTIONS EIN 59-2316866 FSA ADMIN | Claims processing; Contract Administrator Service code 12 | P.O BOX 10269 JACKSONVILLE, FL 32204 | $8K |
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 | 501 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 504 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 454 | $422K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 454 | $422K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 439 | $143K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 421 | $78K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 363 | $112K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 416 | $1.2M |
| Other(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 439 | $168K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 454 | — |
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.