| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200GALLERIA PKWY SE STE 1950 ATLANTA, GA 30339 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $42K | — | $42K | 3.00% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 30339 | METROPOLITAN LIFE INSURANCE COMPANY | $16K | $2K | $19K | 11.03% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 30339 | KAISER FOUNDATION HEALTH PLAN INC. | $2K | — | $2K | 4.33% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 155 N WACKER DR STE 1500 CHICAGO, IL 60606 | KAISER FOUNDATION HEALTH PLAN INC. | $201 | — | $201 | 0.41% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 30339 | VISION SERVICE PLAN | $3K | — | $3K | 18.41% |
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 | 904 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 904 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 74 | $1.5M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 74 | $1.4M |
| Vision(4 contracts) | VISION SERVICE PLAN | 182 | $54K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 904 | $168K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 904 | $168K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 904 | $168K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 904 | $168K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 904 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.