| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, LLC | 200 GALLERIA PKWY., STE 1950 ATLANTA, GA 30339 | DELTA DENTAL PLAN OF ARKANSAS | $20K | — | $20K | 9.51% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, LLC | 200 GALLERIA PKWY., STE 1950 ATLANTA, GA 30339 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $16K | $10K | $26K | 16.21% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, LLC | 200 GALLERIA PKWY., STE 1950 ATLANTA, GA 30339 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $5K | $12K | 16.63% |
| PLAN SOURCE BENEFIT ADMINISTRATORS5 Filed as: PLAN SOURCE BEN. ADMINISTRATOR, INC | P.O. BOX 1313 ORLANDO, FL 32802 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 2.81% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, LLC | 200 GALLERIA PKWY., STE 1950 ATLANTA, GA 30339 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $2K | $6K | 15.05% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, LLC | 200 GALLERIA PKWY., STE 1950 ATLANTA, GA 30339 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $5K | 16.07% |
| PLAN SOURCE BENEFIT ADMINISTRATORS5 Filed as: PLAN SOURCE BEN. ADMINISTRATOR, INC | P.O. BOX 1313 ORLANDO, FL 32802 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $2K | $2K | 6.15% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DIGITAL INSURANCE, LLC NONE | Insurance brokerage commissions and fees; Other services Service code 49 | 200 GALLERIA PKWY., STE 1950 ATLANTA, GA 30339 | $36K |
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 | 410 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 413 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ARKANSAS BLUE CROSS AND BLUE SHIELD | 552 | $3.1M |
| Dental | DELTA DENTAL PLAN OF ARKANSAS | 571 | $210K |
| Vision | ARKANSAS BLUE CROSS AND BLUE SHIELD | 572 | $33K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 832 | $41K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 447 | $70K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 625 | $158K |
| Prescription drug | ARKANSAS BLUE CROSS AND BLUE SHIELD | 552 | $3.1M |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 832 | $73K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 832 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.