| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PKWY SE SUITE 1950 ATLANTA, GA 30339 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $3K | $3K | 0.41% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | $4K | — | $4K | 4.37% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | $4K | — | $4K | 11.36% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | $2K | — | $2K | 8.81% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | $1K | — | $1K | 11.32% |
| ENROLLEASE3 Filed as: ONE DIGITAL - ATLANTA GA | ATTN ACCOUNT MANAGEMENT ATLANTA, GA 30339 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $815 | — | $815 | 9.95% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $0 | $891 | $891 | — |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $0 | $226 | $226 | — |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $0 | $318 | $318 | — |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $0 | $114 | $114 | — |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 303395946 | PRINCIPAL LIFE INSURANCE COMPANY | $138 | — | $138 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 NONE | Non-monetary compensation; Other services; Direct payment from the plan; Contract Administrator; Claims processing; Named fiduciary; Participant communication; Float revenue Service code 12 | — | $132K |
| DIGITAL INSURANCE INC NONE | Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | 200 GALLERIA PKWY SE SUITE 1950 ATLANTA, GA 30339 | $70K |
| CLARITY BENEFIT SOLUTIONS NONE | Claims processing; Contract Administrator Service code 12 | 77 BRANT AVENUE CLARK, NJ 07066 | $8K |
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 | 162 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 164 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 203 | $725K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 203 | $0 |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 129 | $8K |
| Life insurance(2 contracts, 2 carriers) | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | 196 | $89K |
| Short-term disability(2 contracts, 2 carriers) | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | 85 | $25K |
| Long-term disability(2 contracts, 2 carriers) | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | 81 | $31K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 165 | $725K |
| Other(6 contracts, 3 carriers) | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | 203 | $157K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 203 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.