| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CORE BENEFIT SOLUTIONS LLC3 | 1447 PEACHTREE ST STE 360 ATLANTA, GA 30309 | BLUE CROSS BLUE SHIELD HEALTHCARE OF GEORGIA | $46K | — | $46K | 4.27% |
| CORE BENEFIT SOLUTIONS LLC3 Filed as: CORE BENEFIT SOLUTIONS | 1411 DUTCH VALLEY PL NE ATLANTA, GA 30324 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $58 | $1K | 15.76% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE | SERVICES 808 GLENDALOUGH RD ERDENHEIM, PA 19038 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $17 | $17 | 0.22% |
| CORE BENEFIT SOLUTIONS LLC3 Filed as: CORE BENEFIT SOLUTIONS | 1411 DUTCH VALLEY PL NE ATLANTA, GA 30324 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $882 | $45 | $927 | 15.77% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 808 GLENDALOUGH RD ERDENHEIM, PA 19038 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $13 | $13 | 0.22% |
| CORE BENEFIT SOLUTIONS LLC3 Filed as: CORE BENEFIT SOLUTIONS | 1411 DUTCH VALLEY PL NE ATLANTA, GA 30324 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $800 | $149 | $949 | 17.80% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE GROWTH | SERVICES 808 GLENDALOUGH RD ERDENHEIM, PA 19038 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $43 | $43 | 0.81% |
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 | 158 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 158 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD HEALTHCARE OF GEORGIA | 158 | $1.1M |
| Dental | BLUE CROSS BLUE SHIELD HEALTHCARE OF GEORGIA | 158 | $1.1M |
| Vision | BLUE CROSS BLUE SHIELD HEALTHCARE OF GEORGIA | 158 | $1.1M |
| Life insurance(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD HEALTHCARE OF GEORGIA | 158 | $1.1M |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 39 | $8K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 39 | $6K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 90 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 158 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.