| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BEVCAP MANAGEMENT LLC3 Filed as: BEVCAP MANAGEMENT | 120 W VIRGINIA ST, STE 200 MCKINNEY, TX 75069 | BERKLEY LIFE & HEALTH INSURANCE COMPANY | $0 | $131K | $131K | 26.78% |
| PARNTERS BENEFIT GROUP LLC3 | 1476 CARPENTER ROAD TIFTON, GA 31793 | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | $25K | $0 | $25K | 11.24% |
| PARTNERS BENEFIT GROUP LLC3 | 1476 CARPENTER RD S TIFTON, GA 31793 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $25K | — | $25K | 18.00% |
| PLANSOURCE BEN ADMINISTRATION INC5 | PO BOX 1313 ORLANDO, FL 32802 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $13K | $13K | 9.00% |
| PARTNERS BENEFIT GROUP LLC3 | 1476 CARPENTER RD S TIFTON, GA 31793 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 1.91% |
| PARTNERS BENEFIT GROUP LLC3 | 1476 CARPENTER RD S TIFTON, GA 31793 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $11K | — | $11K | 15.00% |
| PLANSOURCE BEN ADMINISTRATION INC5 | PO BOX 1313 ORLANDO, FL 32802 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $7K | $7K | 9.00% |
| PARTNERS BENEFIT GROUP LLC3 | 1476 CARPENTER RD S TIFTON, GA 31793 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $707 | $707 | 0.95% |
| PARNTERS BENEFIT GROUP LLC3 | 1476 CARPENTER ROAD S TIFTON, GA 31793 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | — | $6K | 10.00% |
| PARTNERS BENEFIT GROUP LLC3 | 1476 CARPENTER ROAD S TIFTON, GA 31793 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 1.86% |
| PARTNERS BENEFIT GROUP LLC3 | 1476 CARPENTER ROAD S TIFTON, GA 31793 | 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 | — | $942 | $942 | 7.20% |
| PARTNERS BENEFIT GROUP LLC3 | 1476 CARPENTER RD S TIFTON, GA 31793 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $256 | $256 | 1.96% |
| PARTNERS BENEFIT GROUP LLC3 | 1476 CARPENTER RD S TIFTON, GA 31793 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $861 | — | $861 | 14.99% |
| PARTNERS BENEFIT GROUP LLC3 | 1476 CARPENTER RD S TIFTON, GA 31793 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $794 | $794 | 13.83% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD HEALTHCARE P EIN 58-1638390 | Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Contract Administrator; Claims processing Service code 12 | — | $75K |
| INGENIORX, INC. | Contract Administrator; Claims processing; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services Service code 12 | — | $3K |
| PARTNERS BENEFIT GROUP ..C | Insurance agents and brokers; Other commissions; 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 | 743 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 743 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BERKLEY LIFE & HEALTH INSURANCE COMPANY | 715 | $487K |
| Dental | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | 743 | $225K |
| Vision(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | 743 | $255K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 570 | $154K |
| Short-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 541 | $80K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 570 | $62K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 743 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.