| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STEVEN NEEDLE3 | 2405 SATELLITE BLVD SUITE 200 DULUTH, GA 30096 | BLUE CROSS BLUE SHIELD OF TENNESSEE INC | $42K | — | $42K | 5.02% |
| MARTIN KOOPER3 | 770 LEXINGTON AVENUE #14 NEW YORK, NY 10065 | BLUE CROSS BLUE SHIELD OF TENNESSEE INC | $1K | — | $1K | 0.12% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P O BOX 102159 PASADENA, CA 91189 | HARTFORD LIFE INSURANCE COMPANY | — | $9K | $9K | 1.56% |
| JAMES RAIOLA3 | 125 METRO CENTER BOULEVARD WARWICK, RI 02818 | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | $310 | $8K | $9K | 3.12% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 2405 SATELLITE BOULEVARD SUITE 200 DULUTH, GA 30096 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $20K | — | $20K | 13.28% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P O BOX 102159 PASADENA, CA 91189 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $3K | $3K | 2.00% |
| BUCKINGHAM INSURANCE SERVICES, INC.3 Filed as: BUCKINGHAM INSURANCE SERVICES INC | 301 HYDE PARK DOYLESTOWN, PA 18901 | GARDEN STATE LIFE INSURANCE COMPANY | $46K | — | $46K | 50.02% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 2405 SATELLITE BOULEVARD SUITE 125 DULUTH, GA 30096 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | — | $2K | 9.87% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 2405 SATELLITE BOULEVARD SUITE 200 DULUTH, GA 30096 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 18.55% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P O BOX 511398 LOS ANGELES, CA 90051 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $184 | $184 | 1.86% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MERITAIN HEALTH EIN 16-1264154 NONE | Claims processing; Plan Administrator; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $658K |
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 | 804 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 12 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 816 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN OF GEORGIA | 474 | $3.3M |
| Dental(3 contracts, 3 carriers) | BLUE CROSS BLUE SHIELD OF TENNESSEE INC | 226 | $1.1M |
| Vision(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF TENNESSEE INC | 1,690 | $964K |
| Life insurance(4 contracts, 3 carriers) | HARTFORD LIFE INSURANCE COMPANY | 1,617 | $788K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 434 | $151K |
| Long-term disability(2 contracts, 2 carriers) | HARTFORD LIFE INSURANCE COMPANY | 1,617 | $755K |
| Stop-loss / reinsurancereinsurance | GARDEN STATE LIFE INSURANCE COMPANY | 93 | $92K |
| Other(3 contracts, 2 carriers) | HARTFORD LIFE INSURANCE COMPANY | 1,617 | $765K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,690 | — |
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.