| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RELATION INSURANCE INC3 | 5825 MEDLOCK BRIDGE PARKWAY SUITE 200 ALPHARETTA, GA 30022 | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA | $129K | $5K | $134K | 3.75% |
| RELATION INSURANCE INC3 | 5825 MEDLOCK BRIDGE PARKWAY SUITE 200 APPLE CENTRAL LLC, GA 30022 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | — | $5K | 10.00% |
| RELATION INSURANCE INC3 | 5825 MEDLOCK BRIDGE PARKWAY SUITE 200 APPLE CENTRAL LLC, GA 30022 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | — | $5K | 10.00% |
| RELATION INSURANCE INC3 | 5825 MEDLOCK BRIDGE PARKWAY SUITE 200 ALPHARETTA, GA 30022 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 10.00% |
| RELATION INSURANCE INC3 | 5825 MEDLOCK BRIDGE ROAD SUITE 200 APPLE CENTRAL LLC, GA 30022 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $985 | — | $985 | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EVERNORTH BEHAVIORAL HEALTH INC EIN 41-1648670 CLAIMS PROCESSING | Claims processing; Participant communication; Direct payment from the plan; Contract Administrator Service code 12 | — | $33K |
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 | 335 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 335 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA | 821 | $3.6M |
| Dental | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA | 821 | $3.6M |
| Vision | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA | 821 | $3.6M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 554 | $40K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 554 | $51K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 554 | $51K |
| Other(4 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 554 | $152K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 821 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.