| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LIPSCOMB & PITTS INSURANCE LLC3 | 2670 UNION AVE EXT STE 200 MEMPHIS, TN 381124416 | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA | $71K | — | $71K | 4.56% |
| LIPSCOMB & PITTS INSURANCE LLC3 Filed as: LIPSCOMB & PITTS INS LLC | 2670 UNION AVE EXT STE 200 MEMPHIS, TN 381124416 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $29K | $3K | $32K | 13.70% |
| MJ INSURANCE3 Filed as: VARIOUS AGENTS - SEE ATTACHMENT | 1932 WYNNTON ROAD DEPT 434CK COLUMBUS, GA 31999 | AFLAC | $5K | $72 | $5K | 25.24% |
| RICHARD DE ASIS3 | 146 KEMP DRIVE MACEDON, NY 14502 | AFLAC | $2K | $186 | $3K | 28.99% |
| BRENDAN MCCARTHY AND CREW INC3 Filed as: BRENDAN MCCARTHY AND CREW INC. | 1411 CHILI AVENUE SUITE 100 ROCHESTER, NY 14624 | AFLAC | $326 | $37 | $363 | 4.07% |
| JUSTIN VIELE3 | 622 BENNINGTON DRIVE ROCHESTER, NY 14624 | AFLAC | $124 | $11 | $135 | 1.51% |
| RANDI E RIVA3 Filed as: RANDI RIVA | 340 W. PALMETTO PARK ROAD UNIT 504B ROCHESTERBOCA RATON, FL 33432 | AFLAC | $4 | — | $4 | 0.04% |
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 | 217 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 218 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA | 270 | $1.5M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 218 | $231K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 218 | $231K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 218 | $231K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 218 | $231K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 218 | $231K |
| Other(3 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 218 | $260K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 270 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.