| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| REFINED BENEFITS DBA SULLIVAN3 Filed as: REFINED BENEFITS INC DBA SULLIVAN | 10672 BLOOMINGDALE AVE SUITE 102 RIVERVIEW, FL 33578 | SUN LIFE ASSURANCE COMPANY OF CANADA | $52K | $15K | $67K | 12.01% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 200 GALLERIA PARKWAY ST. SUITE 1950 ATLANTA, GA 303395946 | SUN LIFE ASSURANCE COMPANY OF CANADA | $9K | — | $9K | 1.58% |
| UMR, INC.3 | 11 SCOTT ST SUITE 100 WAUSAU, WI 54403 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $4K | $4K | 0.65% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 1105 NIKKI VIEW DR BRANDON, FL 33511 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 4.01% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 200 GALLERIA PARKWAY ST. SUITE 1950 ATLANTA, GA 303395946 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $1K | $5K | $7K | 2.94% |
| VARIOUS - SEE ATTACHED3 Filed as: AFLAC - SEE ADDENDUM LISTING | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $30K | $2K | $32K | 17.93% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 200 GALLERIA PARKWAY ST. SUITE 1950 ATLANTA, GA 303395946 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $10K | — | $10K | 10.00% |
| REFINED BENEFITS DBA SULLIVAN3 Filed as: REFINED BENEFITS INC | 10672 BLOOMINGDALE AVE SUITE 102 RIVERVIEW, FL 33578 | SUN LIFE ASSURANCE COMPANY OF CANADA | $4K | — | $4K | 9.14% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 200 GALLERIA PARKWAY ST. SUITE 1950 ATLANTA, GA 303395946 | SUN LIFE ASSURANCE COMPANY OF CANADA | $1K | — | $1K | 2.33% |
| MEDICAL GROUP INSURANCE SERVICES5 Filed as: MEDICAL GROUP INSURANCE SVCS INC | 111 SOUTH MAIN STREET SUITE 400 SALT LAKE CITY, UT 841112176 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $195 | $195 | 0.44% |
| REFINED BENEFITS DBA SULLIVAN3 | 1105 NIKKI VIEW DR BRANDON, FL 33511 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | — | $1K | 6.51% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 200 GALLERIA PARKWAY ST. SUITE 1950 ATLANTA, GA 303395946 | PRINCIPAL LIFE INSURANCE COMPANY | $131 | — | $131 | 0.65% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSOR | Claims processing Service code 12 | — | $275K |
| REFINED BENEFITS, INC. DBA SULLIVAN EIN 59-3652048 INS BROKER | Other commissions Service code 55 | 10672 BLOOMINGDALE AVE RIVERVIEW, FL 33578 | $66K |
| DIGITAL INSURANCE, INC. EIN 58-2522668 BROKER | Other commissions Service code 55 | 200 GALLERIA PARKWAY SE SUITE 1950 ATLANTA, GA 303395946 | $21K |
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 | 540 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 542 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 399 | $228K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 399 | $228K |
| Life insurance(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 516 | $65K |
| Long-term disability | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 526 | $97K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 474 | $555K |
| Other(3 contracts, 3 carriers) | AFLAC | 536 | $232K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 536 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.