| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 303395946 | VISION SERVICE PLAN | $8K | — | $8K | 9.96% |
| OPTIMAL BENEFITS INSURANCE SERVICES3 Filed as: OPTIMAL BENEFITS & INSURANCE SERVIC | 7755 IRVINE CENTER DR STE 500 IRVINE, CA 926182908 | VISION SERVICE PLAN | $2 | — | $2 | 0.00% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 303395946 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $11K | $921 | $12K | 21.65% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 303395946 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9K | $776 | $10K | 23.73% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 303395946 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | $341 | $5K | 21.48% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 7755 IRVINE CENTER DRIVE, 5TH FLOOR IRVINE, CA 92618 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 10.00% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $5K | — | $5K | 64.28% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PARKWAY, SUITE 1950 ATLANTA, GA 30339 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $4K | — | $4K | 67.19% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 303395946 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $101 | $1K | 21.68% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $3K | — | $3K | 64.09% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 7755 IRVINE CENTER DR 5TH FL IRVINE, CA 92618 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $276 | — | $276 | 10.01% |
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 | 690 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 690 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HAWAII MEDICAL SERVICE ASSOCIATION | 120 | $683K |
| Dental | HAWAII MEDICAL SERVICE ASSOCIATION | 120 | $683K |
| Vision(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 601 | $763K |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 747 | $72K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 48 | $23K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 44 | $42K |
| Prescription drug | HAWAII MEDICAL SERVICE ASSOCIATION | 120 | $683K |
| Other(6 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 747 | $69K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 747 | — |
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.