Form 5500 · Employee benefit plan · ATLANTA, GA
OM PARTNERS USA, INC.
The filing calls this plan OM PARTNERS USA, INC. WELFARE BENEFIT PLAN.
OM PARTNERS USA, INC. of ATLANTA, GA files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is DIGITAL INSURANCE INC.. Coverage is written through CIGNA HEALTH AND LIFE INSURANCE COMPANY and 2 other carriers. The plan's most recent policy period ended in November.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 13-4258197 · plan 501 · plan year 2025, filed Apr 14, 2026
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How this plan is funded
Fully insured as reported
The filing reports medical coverage through an insurance contract on Schedule A, and no money paid for benefits by the plan itself.
Benefits declared on this filing
Also declared: death benefits.
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 3 insured contracts covering health, dental, vision, life and disability; the largest, with CIGNA HEALTH AND LIFE INSURANCE COMPANY, covers 241 people.
Reported premium across the insured contracts is $824,211, with $115,311 in disclosed broker commissions — about 14% of premium.
The most recent policy period ended in November, and the plan year ends November 30. Group contracts typically renew on that annual cycle.
DIGITAL INSURANCE INC. is the broker of record on all 3 contracts.
3 carriers appear on the filing, including CIGNA HEALTH AND LIFE INSURANCE COMPANY, STARMOUNT LIFE INSURANCE COMPANY and UNUM LIFE INSURANCE COMPANY OF AMERICA. CIGNA HEALTH AND LIFE INSURANCE COMPANY writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY | Health | 241 | Dec 1, 2025 | $593,582 | $84,645 |
| STARMOUNT LIFE INSURANCE COMPANY | Dental, Vision | 181 | Dec 1, 2025 | $149,930 | $18,561 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA | Life, Disability | 208 | Dec 1, 2025 | $80,699 | $12,105 |
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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