| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY, SUITE 1950 ATLANTA, GA 303395946 | CALIFORNIA PHYSICIANS SERVICE | $3K | $66K | $69K | 4.29% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES | 1600 W. HILLSDALE BOULEVARD SUITE 201 SAN MATEO, CA 94402 | CALIFORNIA PHYSICIANS SERVICE | — | $34K | $34K | 2.08% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 303395946 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $6K | $13K | 8.56% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 303395946 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $6K | 17.00% |
| PAYCHEX INSURANCE AGENCY, INC.5 Filed as: PAYCHEX INSURANCE AGENCY INC. | 150 SAWGRASS DRIVE ROCHESTER, NY 14620 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $864 | $864 | 2.48% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 303395946 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $5K | 17.38% |
| PAYCHEX INSURANCE AGENCY, INC.5 Filed as: PAYCHEX INSURANCE AGENCY INC. | 150 SAWGRASS DRIVE ROCHESTER, NY 14620 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $864 | $864 | 3.24% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 303395946 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $1K | $3K | 16.48% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 303395946 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 21.94% |
| PAYCHEX INSURANCE AGENCY, INC.5 Filed as: PAYCHEX INSURANCE AGENCY INC. | 150 SAWGRASS DRIVE ROCHESTER, NY 14620 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $864 | $864 | 5.12% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 303395946 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $849 | $2K | 15.46% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 303395946 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $950 | $2K | 16.40% |
| LONDONO MILLER BENEFITS INC4 Filed as: LONDONO MILLER BENEFITS INC. | 28326 ATLEY COURT SAUGUS, CA 91350 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $100 | — | $100 | 4.48% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $82 | — | $82 | 3.67% |
| CHRISTA G AUFDEMBERG INC4 Filed as: CHRISTA G. AUFDEMBERG INC. | 13102 BRITTANY WOODS DRIVE TUSTIN, CA 92780 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $32 | — | $32 | 1.43% |
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 | 144 | 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) | 145 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS SERVICE | 260 | $1.6M |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 133 | $157K |
| Vision | CALIFORNIA PHYSICIANS SERVICE | 260 | $1.6M |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 146 | $61K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 55 | $17K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 146 | $19K |
| Prescription drug | CALIFORNIA PHYSICIANS SERVICE | 260 | $1.6M |
| Other(5 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 146 | $94K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 260 | — |
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.