| 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 | $83K | — | $83K | 4.66% |
| 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 | $31K | $10K | $42K | 16.47% |
| MJ INSURANCE3 Filed as: VARIOUS AGENTS - SEE ATTACHMENT | 1932 WYNNTON ROAD DEPT 434CK COLUMBUS, GA 31999 | AFLAC | $4K | $280 | $4K | 20.71% |
| RICHARD DE ASIS3 | 146 KEMP DRIVE MACEDON, NY 14502 | AFLAC | $1K | $141 | $1K | 13.62% |
| BRENDAN MCCARTHY AND CREW INC3 Filed as: BRENDAN MCCARTHY AND CREW INC. | 39 SAGINAW DR SUITE 2 ROCHESTER, NY 14623 | AFLAC | $182 | $24 | $206 | 2.15% |
| STARTING LINE SOLUTIONS INC3 | 279 RIVER ST ROCHESTER, NY 14612 | AFLAC | $25 | — | $25 | 0.26% |
| STARTING LINE SOLUTIONS INC3 | 7 RUSH WEST RUSH RD RUSH, NY 14543 | AFLAC | $15 | — | $15 | 0.16% |
| JUSTIN VIELE3 | 622 BENNINGTON DRIVE ROCHESTER, NY 14624 | AFLAC | $10 | — | $10 | 0.10% |
| RANDI E RIVA3 Filed as: RANDI RIVA | 340 W. PALMETTO PARK ROAD UNIT 504B ROCHESTERBOCA RATON, FL 33432 | AFLAC | $2 | — | $2 | 0.02% |
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 | 257 | 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) | 258 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA | 437 | $1.8M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 259 | $253K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 259 | $253K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 259 | $253K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 259 | $253K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 259 | $253K |
| Other(3 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 259 | $282K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 437 | — |
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."
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.