| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| REFINED BENEFITS DBA SULLIVAN3 | 10672 BLOOMINGDALE AVE SUITE 102 RIVERVIEW, FL 33578 | SUN LIFE ASSURANCE COMPANY OF CANADA | $71K | $19K | $91K | 10.59% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY ST. SUITE 1950 ATLANTA, GA 303395946 | SUN LIFE ASSURANCE COMPANY OF CANADA | $14K | — | $14K | 1.68% |
| DIGITAL INSURANCE LLC3 | 1106 NIKKI VIEW DRIVE RIVERVIEW, FL 33578 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $12K | — | $12K | 8.35% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY ST. SUITE 1950 ATLANTA, GA 303395946 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $5K | $7K | 5.28% |
| VARIOUS - SEE ATTACHED3 Filed as: AFLAC - SEE ADDENDUM LISTING | 1932 WYNNTON RD COLUMBUS, GA 31999 | AFLAC | $22K | $1K | $23K | 17.36% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY ST. SUITE 1950 ATLANTA, GA 303395946 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $267 | $6K | 15.75% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY ST. SUITE 1950 ATLANTA, GA 303395946 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 14.71% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 738 N FIRST STREET SAN JOSE, CA 95112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $937 | $125 | $1K | 17.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| REFINED BENEFITS/SULLIVAN BROKER | Insurance agents and brokers Service code 22 | 10672 BLOOMINGDALE AVENUE SUITE 102 RIVERVIEW, FL 33578 | $123K |
| MERITAN HEALTH EIN 16-1264154 TPA | Claims processing Service code 12 | — | $90K |
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 | 268 | 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) | 269 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 245 | $138K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 245 | $138K |
| Life insurance(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 280 | $63K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 280 | $21K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 280 | $21K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 208 | $854K |
| Other(3 contracts, 3 carriers) | AFLAC | 280 | $191K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 280 | — |
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.