| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PARTNERS BENEFIT GROUP LLC3 | 1201 WILLIAMS ST VALDOSTA, GA 31601 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $24K | — | $24K | 18.00% |
| PLANSOURCE BEN ADMINISTRATION INC5 | PO BOX 1313 ORLANDO, FL 32802 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $12K | $12K | 9.00% |
| PARTNERS BENEFIT GROUP LLC3 | 1476 CARPENTER RD S TIFTON, GA 31793 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 2.11% |
| PARTNERS BENEFIT GROUP LLC3 | — | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | — | $6K | 10.00% |
| PARTNERS BENEFIT GROUP LLC3 | 1476 CARPENTER RD S TIFTON, GA 31793 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 2.09% |
| PARTNERS BENEFIT GROUP LLC3 | 1201 WILLIAMS ST VALDOSTA, GA 31601 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | — | $6K | 15.00% |
| PLANSOURCE BEN ADMINISTRATION INC5 | PO BOX 1313 ORLANDO, FL 32802 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 8.44% |
| PARTNERS BENEFIT GROUP LLC3 | 1476 CARPENTER RD S TIFTON, GA 31793 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 3.88% |
| PARTNERS BENEFIT GROUP LLC3 | 1201 WILLIAMS ST VALDOSTA, GA 31601 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 15.00% |
| PLANSOURCE BEN ADMINISTRATION INC5 | PO BOX 1313 ORLANDO, FL 32802 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 9.00% |
| PARTNERS BENEFIT GROUP LLC3 | 1201 WILLIAMS ST VALDOSTA, GA 31601 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| PLANSOURCE BEN ADMINISTRATION INC5 | PO BOX 1313 ORLANDO, FL 32802 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $923 | $923 | 7.20% |
| PARNTERS BENEFIT GROUP LLC3 | 1476 CARPENTER RD S TIFTON, GA 31793 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $267 | $267 | 2.08% |
| PARTNERS BENEFIT GROUP LLC3 | 1476 CARPENTER ROAD TIFTON, GA 31793 | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC | $23K | $1K | $24K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD HEALTHCARE P EIN 58-1638390 | Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Claims processing; Other services; Contract Administrator Service code 12 | — | $689K |
| INGENIORX INC | Other services; Claims processing; Contract Administrator; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $0 |
| PARTNERS BENEFIT GROUP LLC | Other commissions; Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | PO 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 | 711 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 711 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | BLUE CROSS AND BLUE SHIELD OF GEORGIA INC | 711 | $216K |
| Vision | BLUE CROSS AND BLUE SHIELD OF GEORGIA INC | 711 | $216K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 544 | $148K |
| Short-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 514 | $75K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 543 | $58K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC | 684 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 711 | — |
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.