| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUTCHISON-TRAYLOR INS AGENCY3 | PO BOX 1049 LAGRANGE, GA 30240 | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA INC | $151K | — | $151K | 3.41% |
| HUTCHISON-TRAYLOR INS AGENCY3 | PO BOX 1049 LAGRANGE, GA 302410019 | STANDARD INSURANCE COMPANY | $37K | — | $37K | 9.86% |
| HUTCHISON-TRAYLOR INS AGENCY3 | PO BOX 1049 LAGRANGE, GA 30240 | BLUE CROSS BLUE SHIELD OF GEORGIA INC | $18K | — | $18K | 5.00% |
| VARIOUS - SEE ATTACHED3 Filed as: AFLAC - MULTIPLE PAYEES | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC (THC) | $16K | $161 | $16K | 14.76% |
| VARIOUS - SEE ATTACHED3 Filed as: AFLAC - MULTIPLE PAYEES | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC (JHMH) | $20K | $389 | $20K | 22.40% |
| HUTCHISON-TRAYLOR INS AGENCY3 | PO BOX 1049 LAGRANGE, GA 30240 | BLUE CROSS BLUE SHIELD OF GEORGIA INC | $2K | — | $2K | 3.38% |
| VARIOUS - SEE ATTACHED3 Filed as: AFLAC - MULTIPLE PAYEES | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC (HSC) | $3K | $43 | $3K | 27.16% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MEDCOM SERVICES INC FSA/COBRA ADMIN | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Other services Service code 12 | PO BOX 10269 JACKSONVILLE, FL 322470269 | $12K |
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 | 569 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 13 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 582 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA INC | 900 | $4.4M |
| Dental | BLUE CROSS BLUE SHIELD OF GEORGIA INC | 469 | $364K |
| Vision | BLUE CROSS BLUE SHIELD OF GEORGIA INC | 816 | $57K |
| Life insurance | STANDARD INSURANCE COMPANY | 548 | $376K |
| Long-term disability | STANDARD INSURANCE COMPANY | 548 | $376K |
| Prescription drug | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA INC | 900 | $4.4M |
| Other(3 contracts, 3 carriers) | AFLAC (THC) | 128 | $209K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 900 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.