| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY, SUITE 1950 ATLANTA, GA 30339 | CALIFORNIA PHYSICIANS SERVICE | $40 | $249K | $249K | 2.84% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | CALIFORNIA PHYSICIANS SERVICE | — | $15K | $15K | 0.17% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY, SUITE 1950 ATLANTA, GA 30339 | DELTA DENTAL OF CALIFORNIA | $36K | — | $36K | 6.00% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 30339 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $15K | $11K | $27K | 17.12% |
| VARIOUS - SEE ATTACHED3 Filed as: VARIOUS SEE ATTACHED AFLAC SCHEDULE | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $22K | $636 | $23K | 15.45% |
| ENROLLEASE3 Filed as: ONE DIGITAL | 200 GALLERIA PARKWAY, SUITE 1950 ATLANTA, GA 30339 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $13K | — | $13K | 9.15% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 30339 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $13K | $10K | $23K | 17.74% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 30339 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $12K | $8K | $20K | 16.93% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY, SUITE 1950 ATLANTA, GA 30339 | DELTA DENTAL OF CALIFORNIA | $5K | — | $5K | 6.00% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY, SUITE 1950 ATLANTA, GA 30339 | DELTA DENTAL OF CALIFORNIA | $3K | — | $3K | 6.00% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 30339 | DELTA DENTAL OF CALIFORNIA | $5K | — | $5K | 10.00% |
| CHRISTA G AUFDEMBERG INC4 Filed as: CHRISTA G AUFDEMBERG INC. | 13102 BRITTANY WOODS DR TUSTIN, CA 92780 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $497 | — | $497 | 8.28% |
| SANDRA SIMS4 Filed as: SANDRA ALLEN | 501 AGUA PLACE SEAL BEACH, CA 90740 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $70 | — | $70 | 1.17% |
| DIGITAL INSURANCE LLC4 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 30339 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $56 | — | $56 | 0.93% |
| JOHN P. LONDONO4 | 4621 N LEAVITT ST APT 3 CHICAGO, IL 60625 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $55 | — | $55 | 0.92% |
| LONDONO MILLER BENEFITS INC4 | 28326 ATLEY COURT SAUGUS, CA 91350 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $48 | — | $48 | 0.80% |
| AMY EVANS4 | 1751 COLORADO BLVD LOS ANEGELES, CA 90041 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $21 | — | $21 | 0.35% |
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 | 769 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 31 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 800 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS SERVICE | 1,518 | $8.8M |
| Dental(4 contracts) | DELTA DENTAL OF CALIFORNIA | 1,140 | $791K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 1,627 | $147K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 851 | $276K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,119 | $130K |
| Prescription drug | CALIFORNIA PHYSICIANS SERVICE | 1,518 | $8.8M |
| Other(5 contracts, 4 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 851 | $445K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,627 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.