| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBA PREMIER INSURANCE SOLUTIONS3 Filed as: CBA PREMIER INS SOLUTIONS INC | 2033 GATEWAY PLACE SUITE 500 SAN JOSE, CA 95110 | BLUE SHIELD OF CALIFORNIA | — | $209K | $209K | 5.26% |
| CBA PREMIER INSURANCE SOLUTIONS3 Filed as: CBA PREMIER INS SOLUTIONS INC | 2033 GATEWAY PLACE SUITE 500 SAN JOSE, CA 95110 | BLUE SHIELD OF CALIFORNIA | — | $86 | $86 | 0.00% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY STE 1950 ATLANTA, GA 30339 | STARMOUNT LIFE INSURANCE COMPANY | $28K | $1K | $29K | 10.43% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY STE 1950 ATLANTA, GA 30339 | STARMOUNT LIFE INSURANCE COMPANY | — | $2K | $2K | 0.86% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY STE 1950 ATLANTA, GA 30339 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $11K | $1K | $12K | 4.66% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY STE 1950 ATLANTA, GA 30339 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $3K | $3K | 0.94% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY STE 1950 ATLANTA, GA 30339 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $37K | — | $37K | 15.00% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 303395946 | VISION SERVICE PLAN | $1K | — | $1K | 3.17% |
| CBA PREMIER INSURANCE SOLUTIONS3 Filed as: CBA PREMIER INSURANCE SOLUTIONS, | INC 2033 GATEWAY PL STE 500 SAN JOSE, CA 951103712 | VISION SERVICE PLAN | $907 | — | $907 | 2.04% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY STE 1950 ATLANTA, GA 30339 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $132 | $5K | 15.42% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY STE 1950 ATLANTA, GA 30339 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $273 | $273 | 0.87% |
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 | 284 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 50 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 50 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 384 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE SHIELD OF CALIFORNIA | 250 | $4.0M |
| Dental | STARMOUNT LIFE INSURANCE COMPANY | 272 | $281K |
| Vision | VISION SERVICE PLAN | 268 | $45K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 282 | $298K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 282 | $267K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 282 | $267K |
| Prescription drug | BLUE SHIELD OF CALIFORNIA | 250 | $4.0M |
| Other(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 282 | $543K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 282 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.