| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ENROLLEASE3 Filed as: DIGITAL INSURANE INC DBA ONEDIGITAL | 200 GALLERIA PARKWAY SE SUITE 1950 ATLANTA, GA 30339 | SUN LIFE ASSURANCE COMPANY OF CANADA | $39K | — | $39K | 6.80% |
| REFINED BENEFITS DBA SULLIVAN3 Filed as: REFINED BENEFITS DBA SULLIVAN BENEF | 10672 BLOOMINGDALE AVE SUITE 102 RIVERVIEW, FL 33578 | SUN LIFE ASSURANCE COMPANY OF CANADA | $18K | — | $18K | 3.20% |
| VARIOUS - SEE ATTACHMENT3 | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $33K | $2K | $34K | 15.14% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INS INC | 200 GALLERIA PARKWAY SE SUITE 1950 ATLANTA, GA 303395946 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $1K | $3K | 2.88% |
| REFINED BENEFITS DBA SULLIVAN3 | 10672 BLOOMINGDALE AVENUE SUITE 102 RIVERVIEW, FL 33578 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 1.53% |
| REFINED BENEFITS DBA SULLIVAN3 Filed as: REFINED BENEFITS | 10672 BLOOMINGDALE AVENUE SUITE 102 RIVERVIEW, FL 33578 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $5K | $10K | 14.16% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, LLC | 200 GALLERIA PARKWAY SE SUITE 1950 ATLANTA, GA 30339 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 7.58% |
| REFINED BENEFITS DBA SULLIVAN3 | 1105 NIKKI VIEW DR BRANDON, FL 335114879 | HUMANA INSURANCE COMPANY | $1K | — | $1K | 7.85% |
| ENROLLEASE3 Filed as: DIGITAL INSURANCE INC-GA | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 303395946 | HUMANA INSURANCE COMPANY | $195 | $475 | $670 | 4.31% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $186K |
| DIGITAL INSURANCE INC. EIN 58-2522668 BROKER | Other commissions Service code 55 | 200 GALLERIA PARKWAY SE SUITE 1950 ATLANTA, GA 303395946 | $29K |
| REFINED BENEFITS INC DBA SULLIVAN EIN 59-3652048 BROKER | Other commissions Service code 55 | 10672 BLOOMINGDALE AVENUE RIVERVIEW, FL 33578 | $9K |
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 | 287 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 287 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 517 | $100K |
| Vision | HUMANA INSURANCE COMPANY | 170 | $16K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 276 | $72K |
| Short-term disability | AFLAC | 218 | $227K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 216 | $574K |
| Other(2 contracts, 2 carriers) | AFLAC | 276 | $299K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 517 | — |
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."
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.