| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY STE 1950 ATLANTA, GA 30339 | PACIFICSOURCE HEALTH PLANS | $27K | — | $27K | 3.00% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | — | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 14.99% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE | — | WILLIAMETTE DENTAL OF IDAHO, INC. | $996 | — | $996 | 7.50% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, LLC | 200 GALLERIA PARKWAY SE STE 1950 ATLANTA, GA 30339 | PRINCIPAL LIFE INSURANCE COMPANY | $434 | $417 | $851 | 8.85% |
| CENTRO BENEFITS RESEARCH LLC3 Filed as: CENTRO BENEFITS RESEARCH, LLC | 325 N. KIRKWOOD RD. SUITE 300 KIRKWOOD, MO 63122 | PRINCIPAL LIFE INSURANCE COMPANY | $434 | — | $434 | 4.51% |
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 | 126 | 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) | 126 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | PACIFICSOURCE HEALTH PLANS | 188 | $920K |
| Dental | WILLIAMETTE DENTAL OF IDAHO, INC. | 43 | $13K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 134 | $10K |
| Life insurance | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 128 | $26K |
| Short-term disability | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 128 | $26K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 188 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.