| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 400 GALLERIA PARKWAY SE, SUITE 300 ATLANTA, GA 303393182 | CALIFORNIA PHYSICIANS SERVICE | $50K | — | $50K | 5.94% |
| BRLLC INSURANCE SERVICES3 | 20 ENTERPRISE, SUITE 330 ALISO VIEJO, CA 926567104 | CALIFORNIA PHYSICIANS SERVICE | -$27 | — | -$27 | -0.00% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 175 S. SAN ANTONIO ROAD, SUITE 101 LOS ALTOS, CA 940223748 | KAISER FOUNDATION HEALTH PLAN, INC. | $37K | — | $37K | 5.97% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PARKWAY, SUITE 1950 ATLANTA, GA 303393182 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $12K | $6K | $17K | 17.69% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 303393182 | UNITED HEALTHCARE INSURANCE COMPANY | $2K | — | $2K | 12.24% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200GALLERIA PARKWAY, SUITE 1950 ATLANTA, GA 303393182 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $134 | $1K | 17.01% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PARKWAY, SUITE 1950 ATLANTA, GA 30339 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $138 | $5 | $143 | 4.38% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PARKWAY, SUITE 1950 ATLANTA, GA 30339 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $198 | $3 | $201 | 17.15% |
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 | 266 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 267 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 115 | $1.5M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 261 | $99K |
| Vision | UNITED HEALTHCARE INSURANCE COMPANY | 147 | $14K |
| Life insurance(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 261 | $105K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 16 | $3K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 115 | $1.5M |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 261 | $100K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 261 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.