| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 | P O BOX 1788 GRAND RAPIDS, MI 49501 | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA | $13K | $3K | $16K | 3.82% |
| ACRISURE LLC3 | DBA PEACHTREE BENEFIT GROUP 3580 PIERCE DRIVE NE CHAMBLEE, GA 30341 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $739 | $739 | 2.57% |
| PEACHTREE BENEFIT GROUP INC3 | 3580 PIERCE DRIVE NE SUITE 100 CHAMBLEE, GA 30341 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $332 | — | $332 | 1.15% |
| ACRISURE LLC3 | DBA PEACHTREE BENEFIT GROUP 3580 PIERCE DRIVE NE STE 100 CHAMBLEE, GA 30341 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $464 | $3K | 16.21% |
| PEACHTREE BENEFIT GROUP INC3 | 3580 PIERCE DRIVE NE SUITE 100 CHAMBLEE, GA 30341 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $216 | — | $216 | 1.05% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD HEALTHCARE EIN 58-1638390 CLAIMS ADMIN | Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Claims processing; Contract Administrator Service code 12 | — | $230K |
| ACRISURE LLC | Insurance brokerage commissions and fees; Insurance agents and brokers; Other commissions Service code 22 | — | $55K |
| INGENIORX EIN 82-3062245 CLAIMS ADMIN | Float revenue; Contract Administrator; Claims processing; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | -$35K |
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 | 183 | 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) | 183 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA | 235 | $411K |
| Dental | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA | 235 | $411K |
| Vision | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA | 235 | $411K |
| Life insurance | GREATER GEORGIA LIFE INSURANCE COMPANY | 183 | $7K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 69 | $21K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 54 | $29K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA | 235 | $411K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 235 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.