Form 5500 · Employee benefit plan · MINNETONKA, MN
DIGITAL RIVER, INC.
The filing calls this plan DIGITAL RIVER INC. HEALTH AND WELFARE BENEFITS PLAN.
DIGITAL RIVER, INC. of MINNETONKA, MN spreads its employee benefits across 3 insurance carriers, according to its Form 5500 Schedule A. Its broker of record is MERCER HEALTH & BENEFITS LLC. Coverage is written through MEDICA INSURANCE COMPANY and 2 other carriers. The plan's most recent policy period ended in March.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 41-1901640 · plan 501 · plan year 2025, filed Nov 4, 2025
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How this plan is funded
Funding not settled by the filing
The filing does not report enough to settle how this plan pays for benefits.
Benefits declared on this filing
Declared benefits are the plan’s own line 8b codes on Form 5500. “Not on Schedule A” means no insured contract for that line appears on this filing. That usually means the benefit is self-funded, or it sits under a different plan number.
Persons covered is the count the carrier filed for that policy at the end of its policy year, and it can include dependents. Participants is the plan's own count at the start of its plan year. The two count different people, so a covered figure can be larger.
Plan brief
Schedule A lists 4 insured contracts covering health, vision, life and disability; the largest, with MEDICA INSURANCE COMPANY, covers 217 people.
Reported premium across the insured contracts is $389,611, with $20,707 in disclosed broker commissions — about 5.3% of premium.
The health contract's policy period ended in March, while at least one ancillary line's policy period ended in December. The plan is on a split renewal cycle.
MERCER HEALTH & BENEFITS LLC is the broker of record on 3 of the 4 contracts; the rest name a different broker or none.
3 carriers appear on the filing, including MEDICA INSURANCE COMPANY, STANDARD INSURANCE COMPANY and FIDELITY SECURITY LIFE INSURANCE COMPANY. MEDICA INSURANCE COMPANY writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| MEDICA INSURANCE COMPANY | Health | 217 | Apr 1, 2025 | $378,164 | $18,908 |
| STANDARD INSURANCE COMPANY | Life | 136 | Jan 1, 2026 | $4,959 | $930 |
| STANDARD INSURANCE COMPANY | Disability | 136 | Apr 1, 2025 | $4,079 | $687 |
| FIDELITY SECURITY LIFE INSURANCE COMPANY | Vision | 168 | Apr 1, 2025 | $2,409 | $182 |
Premium and claims on these contracts
STANDARD INSURANCE COMPANY, contract 171855. For the contract year on this filing, the carrier reported $4,959 in premium earned and $-4,622 in claims incurred. Dividing one by the other gives -93%.
STANDARD INSURANCE COMPANY, contract 171855. For the contract year on this filing, the carrier reported $4,079 in premium earned and $-5,582 in claims incurred. Dividing one by the other gives -137%.
- STANDARD INSURANCE COMPANY, contract 171855 reported $9,582 in retention.
- STANDARD INSURANCE COMPANY, contract 171855 reported $9,661 in retention.
Retention is what the carrier kept of the premium after claims, as reported: administration, commissions and other charges.
Only experience-rated contracts report these figures, so most filings leave them blank.
Covered = persons covered at policy year end, as filed on Schedule A for that policy — often certificates or one class, not the whole plan. Premium = the filing’s own premium/charges figure; “—” means not credibly reported.
Administrator and service providers
The plan administrator is from line 3a of the main form. We publish company names only.
Other plans filed by this employer
How this plan compares
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