| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 30339 | COMPANION LIFE INSURANCE COMPANY | $4K | $3K | $7K | 11.84% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 30339 | MUTUAL OF OMAHA INSURANCE COMPANY | $4K | $3K | $6K | 14.38% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 30339 | COMPANION LIFE INSURANCE COMPANY | $2K | $950 | $3K | 14.40% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 30339 | MUTUAL OF OMAHA INSURANCE COMPANY | $2K | $1K | $3K | 15.99% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 30339 | MUTUAL OF OMAHA INSURANCE COMPANY | $958 | $472 | $1K | 14.92% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 30339 | MUTUAL OF OMAHA INSURANCE COMPANY | $843 | — | $843 | 8.81% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PARKWAY STE 1950 ATLANTA, GA 30339 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $364 | $282 | $646 | 7.93% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | METROPOLITAN GENERAL INSURANCE COMPANY | $802 | $44 | $846 | 17.28% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PARKWAY STE 1950 ATLANTA, GA 30339 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $352 | $159 | $511 | 12.75% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 30339 | MUTUAL OF OMAHA INSURANCE COMPANY | $216 | $113 | $329 | 15.22% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 NONE | Named fiduciary; Participant communication; Claims processing; Float revenue; Contract Administrator; Other services; Non-monetary compensation; Direct payment from the plan Service code 12 | — | $142K |
| 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 | $85K |
| HEALTH ADVOCATE SOLUTIONS, INC. EIN 23-3080019 NONE | Other fees; Other services Service code 49 | — | $5K |
| HEALTHEQUITY INC. NONE | Claims processing; Contract Administrator Service code 12 | PO BOX 14053 LEXINGTON, KY 40512 | $3K |
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 | 156 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 159 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 157 | $800K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 109 | $86K |
| Vision | MUTUAL OF OMAHA INSURANCE COMPANY | 93 | $10K |
| Life insurance(3 contracts, 2 carriers) | COMPANION LIFE INSURANCE COMPANY | 156 | $93K |
| Short-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 68 | $18K |
| Long-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 59 | $44K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 157 | $788K |
| Other(8 contracts, 4 carriers) | MUTUAL OF OMAHA INSURANCE COMPANY | 156 | $113K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 157 | — |
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."
No prospect flags tripped on this filing.