| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $0 | $176 | $176 | 0.05% |
| ENROLLEASE3 Filed as: DIGITAL INSURANCE INC DBA | ONEDIGITAL HEALTH AND BENEFITS 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 30339 | SUN LIFE AND HEALTH INSURANCE COMPANY (U.S.) | $7K | $0 | $7K | 8.07% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS LLC | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | SUN LIFE AND HEALTH INSURANCE COMPANY (U.S.) | $513 | $0 | $513 | 0.61% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPIRE HEALTHCHOICE ASSURANCE, INC. EIN 23-7391136 NONE | Float revenue; Claims processing; Contract Administrator; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $342K |
| DELTA DENTAL OF NEW YORK EIN 11-1980218 NONE | Contract Administrator; Claims processing Service code 12 | — | $21K |
| DISCOVERY BENEFITS, LLC. NONE | Contract Administrator; Claims processing Service code 12 | 4321 20TH AVENUE S. FARGO, ND 58103 | $14K |
| DIGITAL INSURANCE LLC NONE | Other commissions; Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | 400 GALLERIA PKWY #300 ATLANTA, GA 30339 | $13K |
| SUN LIFE AND HEALTH INS CO (U.S.) EIN 06-0893662 NONE | Contract Administrator; Claims processing Service code 12 | — | $7K |
| MERCER HEALTH & BENEFITS LLC NONE | Other commissions; Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | $856 |
| DIGITAL INSURANCE INC DBA NONE | Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | ONEDIGITAL HEALTH AND BENEFITS 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 30339 | $354 |
| MERCER HEALTH AND BENEFITS LLC NONE | Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | $129 |
| INGENIORX, INC. EIN 82-3062245 NONE | Contract Administrator; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Float revenue Service code 12 | — | -$78K |
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 | 479 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 487 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 445 | $337K |
| Vision | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 445 | $337K |
| Life insurance | SUN LIFE AND HEALTH INSURANCE COMPANY (U.S.) | 479 | $84K |
| Short-term disability | SUN LIFE AND HEALTH INSURANCE COMPANY (U.S.) | 479 | $84K |
| Long-term disability | SUN LIFE AND HEALTH INSURANCE COMPANY (U.S.) | 479 | $84K |
| Stop-loss / reinsurancereinsurance | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 445 | $337K |
| Other | SUN LIFE AND HEALTH INSURANCE COMPANY (U.S.) | 479 | $84K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 479 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.