| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| REGIONS INSURANCE INC3 Filed as: REGIONS INSURANCE, INC. | PO BOX 2121, DEPT 1336 MEMPHIS, TN 38159 | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC | $1K | — | $1K | 0.34% |
| MOT FINANCIAL SERVICES LLC3 Filed as: MOT FINANCIAL SERVICES | 4 CONCOURSE PKWY, 3RD FLOOR STE 300 ATLANTA, GA 30328 | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC | $1K | — | $1K | 0.28% |
| HARRIS S GREEN3 | 3333 PEACHTREE RD NE STE 550 ATLANT, GA 30326 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $44K | — | $44K | 14.18% |
| MOT FINANCIAL SERVICES LLC3 Filed as: MOT FINANCIAL SERVICES | 3RD FLOOR STE 300 4 CONCOURSE PKWY ATLANT, GA 30328 | PROVIDENT LIFE AND ACCIDENT HEALTH INSURANCE COMPANY | $772 | — | $772 | 6.33% |
| GREEN, HARRIS, SCOTT3 Filed as: GREEN, HARRIS SCOTT | 3333 PEACHTREE RD NE STE 550 ATLANT, GA 30326 | PROVIDENT LIFE AND ACCIDENT HEALTH INSURANCE COMPANY | $140 | — | $140 | 1.15% |
| SMITH, THOMAS, CHRISTOPHER3 Filed as: SMITH, THOMAS CHRISTOPHER | P.O.BOX 6650 METAIRIE, LA 70009 | PROVIDENT LIFE AND ACCIDENT HEALTH INSURANCE COMPANY | $47 | — | $47 | 0.39% |
| MOT FINANCIAL SERVICES LLC3 Filed as: MOT FINANCIAL SERVICES | 3RD FLOOR STE 300 4 CONCOURSE PKWY ATLANT, GA 30328 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 12.58% |
| SMITH, THOMAS, CHRISTOPHER3 Filed as: SMITH, THOMAS CHRISTOPHER | P.O.BOX 6650 METAIRIE, LA 70009 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $552 | — | $552 | 5.92% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF GEORGIA EIN 58-0469845 CLAIMS PROCESSING | Contract Administrator; Float revenue; Other services; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other fees Service code 12 | 3350 PEACHTREE ROAD, NE ATLANTA GA, GA 30326 | $245K |
| MOT FINANCIAL SERVICES CLAIMS PROCESSING | Other commissions; Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | 3333 PEACHTREE ROAD, NE ATLANTA, GA 30326 | $45K |
| REGIONS INSURANCE, INC. CLAIMS PROCESSING | Other commissions; Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | P.O. BOX 2121 DEPT 1336 MEMPHIS, TN 38159 | $37K |
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 | 188 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 188 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC | 156 | $111K |
| Vision | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC | 148 | $385K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 188 | $325K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT HEALTH INSURANCE COMPANY | 35 | $12K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 188 | $312K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC | 148 | $385K |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 188 | $334K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 188 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.