| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AON CONSULTING INC3 | 29840 NETWORK PLACE CHICAGO, IL 606731298 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $7K | $7K | 0.93% |
| BENEFITSTORE INC3 | LOCKBOX NUMBER 893383 14501 NORTH PLANO RD, SUITE 100 RICHARDSON, TX 75081 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $14K | $1K | $16K | 13.47% |
| DANIEL H. PATTERSON3 Filed as: DANIEL HAMMOND PATTERSON | 2703 E LAKE ROAD MCDONOUGH, GA 30252 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $14K | — | $14K | 12.54% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE SHIELD HEALTHCARE PLAN OF GA EIN 58-1638390 CONTRACT ADMINISTRATOR | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Float revenue; Other services; Contract Administrator Service code 12 | — | $1.1M |
| DELTA DENTAL INSURANCE COMPANY EIN 94-2761537 CLAIMS ADMINISTRATOR | Direct payment from the plan; Claims processing Service code 12 | — | $70K |
| LINCOLN LIFE ASSURANCE OF BOSTON EIN 04-6076039 CLAIMS ADMINISTRATION | Claims processing; Direct payment from the plan Service code 12 | — | $30K |
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 | 2,031 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,038 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision(4 contracts) | EYEMED VISION CARE | 2,237 | $131K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,976 | $773K |
| Short-term disability | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | 1,443 | $61K |
| Long-term disability | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | 819 | $282K |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,976 | $888K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,976 | — |
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.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.