| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITIAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SE STE 1950 ATLANTA, GA 30339 | BLUECROSS BLUESHEILD OF TEXAS | $78K | — | $78K | 6.09% |
| DIGITIAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SE STE 1950 ATLANTA, GA 30339 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $10K | $2K | $11K | 23.59% |
| PAYCOM PAYROLL LLC5 | 7501 W MEMORIAL RD OKLAHOMA CITY, OK 73142 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 2.83% |
| DIGITIAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SE STE 1950 ATLANTA, GA 30339 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $875 | $5K | 18.62% |
| DIGITIAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SE STE 1950 ATLANTA, GA 30339 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $915 | $5K | 24.10% |
| DIGITIAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SE STE 1950 ATLANTA, GA 30339 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $726 | $4K | 24.37% |
| DIGITIAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SE STE 1950 ATLANTA, GA 30339 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $514 | $2K | 13.65% |
| DIGITIAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SE STE 1950 ATLANTA, GA 30339 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $379 | $2K | 18.89% |
| PAYCOM PAYROLL LLC5 | 7501 W MEMORIAL RD OKLAHOMA CITY, OK 73142 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 14.05% |
| DIGITIAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SE STE 1950 ATLANTA, GA 30339 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $11K | $2K | $14K | 996.27% |
| PAYCOM PAYROLL LLC5 | 7501 W MEMORIAL RD OKLAHOMA CITY, OK 73142 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $1K | $1K | 100.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| RELIASTAR LIFE INSURANCE COMPANY EIN 41-0451140 SERVICE PROVIDER | Recordkeeping fees Service code 64 | P.O. BOX 550 MINOT, ND 58702 | $32K |
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 | 194 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,235 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,429 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHEILD OF TEXAS | 210 | $1.3M |
| Dental(2 contracts, 2 carriers) | BLUECROSS BLUESHEILD OF TEXAS | 210 | $1.3M |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 158 | $14K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 254 | $11K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 161 | $48K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 254 | $24K |
| Other(4 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 254 | $50K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 254 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.