| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PARTNERS BENEFIT GROUP LLC3 | 1476 CARPENTER RD TIFTON, GA 31793 | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | $22K | $0 | $22K | 3.86% |
| PARTNERS BENEFIT GROUP LLC3 | 1476 CARPENTER RD TIFTON, GA 31793 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $23K | $0 | $23K | 18.00% |
| PLANSOURCE BEN ADMINISTRATION INC5 | P.O. BOX 1313 ORLANDO, FL 32802 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $12K | $12K | 9.00% |
| PARTNERS BENEFIT GROUP LLC3 | 1476 CARPENTER RD TIFTON, GA 31793 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $11K | $0 | $11K | 15.00% |
| PLANSOURCE BEN ADMINISTRATION INC5 | P.O. BOX 1313 ORLANDO, FL 32802 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $6K | $6K | 9.00% |
| PARTNERS BENEFIT GROUP LLC3 | 1476 CARPENTER RD TIFTON, GA 31793 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $0 | $6K | 10.00% |
| PARTNERS BENEFIT GROUP LLC3 | 1476 CARPENTER RD TIFTON, GA 31793 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 15.00% |
| PLANSOURCE BEN ADMINISTRATION INC5 | P.O. BOX 1313 ORLANDO, FL 32802 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $915 | $915 | 7.20% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD HEALTHCAE PL EIN 58-1638390 | Other services; Float revenue; Contract Administrator; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $729K |
| INGENIORX, INC. | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Other services; Float revenue; Claims processing Service code 12 | — | $113K |
| PARTNERS BENEFIT GROUP LLC | Insurance brokerage commissions and fees; Insurance agents and brokers; Other commissions Service code 22 | P.O. BOX 7770 TIFTON, GA 31794 | $0 |
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 | 738 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 738 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | BLUE CROSS BLUE SHIELD OF GEORGIA INC | 738 | $217K |
| Vision | BLUE CROSS BLUE SHIELD OF GEORGIA INC | 738 | $217K |
| Life insurance(4 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 539 | $271K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | 704 | $557K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 738 | — |
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.