| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 30339 | BLUE CROSS BLUE SHIELD | $20K | $1K | $21K | 2.18% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST INC | PO BOX 61187 VIRGINIA BEACH, VA 23466 | BLUE CROSS BLUE SHIELD | $9K | — | $9K | 0.98% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PKWY STE 1950 ATLANTA, GA 30339 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 6.76% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST INC | 840 GESSNER STE 600 HOUSTON, TX 77024 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 3.24% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 30339 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $936 | $3K | 15.73% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST INC | PO BOX 61187 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $813 | — | $813 | 4.89% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 30339 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $779 | $2K | 16.01% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST INC | PO BOX 61187 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $645 | — | $645 | 4.88% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 303393182 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $836 | $485 | $1K | 16.25% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST INC | PO BOX 61187 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $383 | — | $383 | 4.71% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 30339 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $787 | $454 | $1K | 16.26% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST INC | PO BOX 61187 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $357 | — | $357 | 4.68% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 30339 | VISION SERVICE PLAN | $514 | — | $514 | 6.76% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST INC | 2711 N HASKEL AVE, STE 2000 DALLAS, TX 75204 | VISION SERVICE PLAN | $246 | — | $246 | 3.24% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PKWY STE 1950 ATLANTA, GA 30339 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $127 | — | $127 | 7.02% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST INC | 840 GESSNER STE 600 HOUSTON, TX 77024 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $53 | — | $53 | 2.93% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY STE 1950 ATLANTA, GA 30339 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $191 | $78 | $269 | 19.55% |
| ERIK G LILJENWALL3 Filed as: ERIK G. LILJENWALL | 4130 SPICEWOOD SPRINGS RD, STE 200 AUSTIN, TX 78759 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $1 | — | $1 | 0.07% |
| WORTHAM SAN ANTONIO INC3 Filed as: JOHN J. MCGURRAN | 15303 N DALLAS PARKWAY, #550 ADDISON, TX 75001 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $1 | — | $1 | 0.07% |
No Schedule C service providers reported on this filing.
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 | 130 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 130 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD | 162 | $965K |
| Dental(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 51 | $45K |
| Vision | VISION SERVICE PLAN | 51 | $8K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 130 | $30K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 46 | $8K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 46 | $8K |
| Other(4 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 130 | $33K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 162 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.