| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY SE SUITE 1950 ATLANTA, GA 30339 | VISION SERVICE PLAN | $1K | $0 | $1K | 5.92% |
| ROGERS BENEFIT GROUP INC Filed as: ROGERS BENEFIT GROUP | 5110 N 40TH STREET STE 234 PHOENIX, AZ 85018 | VISION SERVICE PLAN | $1K | $0 | $1K | 5.51% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ROUNDSTONE INSURANCE EIN 27-0371422 CAPTIVE PLAN | Named fiduciary Service code 31 | 15422 DETROIT AVE LAKEWOOD, OH 44107 | $313K |
| ONE DIGITAL INSURANCE SERVICES EIN 58-2522662 BROKER | Insurance agents and brokers Service code 22 | 200 GALLERIA PKWY SE SUITE 1950 ATLANTA, GA 30339 | $56K |
| LUCENT HEALTH EIN 39-1997579 THIRD PARTY CLAIMS ADMIN | Claims processing Service code 12 | 424 CHURCH STREET NASHVILLE, TN 37219 | $28K |
| CALIFORNIA PHYSICIANS SERVICES EIN 94-0360524 NETWORK LEASE | Insurance services Service code 23 | 50 BEALE STREET SAN FRANCISCO, CA 64105 | $27K |
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 | 106 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 106 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 79 | $20K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 106 | $6K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 4 | $3K |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 106 | $6K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 106 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.