| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $30K | — | $30K | 10.98% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | — | $5K | 20.00% |
| EMPYREAN INSURANCE SERVICES, INC.3 Filed as: EMPYREAN BENEFIT SOLUTIONS INC | 3010 BRIARPARK DR STE 8000 HOUSTON, TX 77042 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $360 | $360 | 1.51% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | — | $5K | 20.00% |
| EMPYREAN INSURANCE SERVICES, INC.3 Filed as: EMPYREAN BENEFIT SOLUTIONS INC | 3010 BRIARPARK DR STE 8000 HOUSTON, TX 77042 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $334 | $334 | 1.44% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 20.00% |
| EMPYREAN INSURANCE SERVICES, INC.3 Filed as: EMPYREAN BENEFIT SOLUTIONS INC | 3010 BRIARPARK DR STE 8000 HOUSTON, TX 77042 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $265 | $265 | 1.48% |
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 | 1,029 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 15 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,044 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 1,071 | $7.2M |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,029 | $361K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,029 | $98K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,029 | $217K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 1,071 | $7.2M |
| Other(5 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,768 | $118K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,768 | — |
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.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.