| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PARKWAY SE SUITE 1950 ATLANTA, GA 30339 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $835 | $6K | 13.50% |
| CENTRO BENEFITS RESEARCH LLC3 | 325 N KIRKWOOD RD SUITE 300 KIRKWOOD, MO 63122 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $2K | $2K | 5.00% |
| PEAK 1 ADMINISTRATION LLC3 Filed as: PEAK ADMINISTRATIVE LLC | 3903 E PRIMROSE LN SUITE 102 POST FALLS, ID 83854 | DEARBORN LIFE INSURANCE COMPANY | $2K | $0 | $2K | 22.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPLOYEE BENEFITS CORPORATION EIN 39-2044064 ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | — | $7K |
| DIGITAL INSURANCE INC. ADMINISTRATOR | Contract Administrator Service code 13 | 200 GALLERIA PARKWAY SE SUITE 1950 ATLANTA, GA 30339 | $6K |
| PEAK1 ADMINISTRATION LLC ADMINISTRATOR | Contract Administrator Service code 13 | 3903 E PRIMROSE LN SUITE 102 POST FALLS, ID 83854 | $2K |
| CENTRO BENEFITS RESEARCH LLC ADMINISTRATOR | Contract Administrator Service code 13 | 325 N KIRKWOOD RD SUITE 300 KIRKWOOD, MO 63122 | $2K |
| BR1932 DIGITAL INSURANCE LLC AKA ON ADMINISTRATOR | Contract Administrator Service code 13 | 200 GALLERIA PARKWAY SE SUITE 1950 ATLANTA, GA 30339 | $329 |
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 | 111 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 5 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 116 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 112 | $42K |
| Short-term disability | DEARBORN LIFE INSURANCE COMPANY | 43 | $10K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 112 | $42K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 269 | $649K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 269 | — |
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.