| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE A.I. GROUP / REGIONS3 | PO BOX 81308 ATHENS, GA 30608 | STANDARD INSURANCE COMPANY | $304K | $47K | $351K | 16.59% |
| VAGIB CORP3 | URB. ROOSEVELT 482 CESAR GONZALEZ SAN JUAN, PR 00918 | MCS LIFE INSURANCE COMPANY | $8K | — | $8K | 3.88% |
| REGIONS INSURANCE INC3 Filed as: REGIONS INSURANCE | 12725 MORRIS BLVD. BLDG. B, STE. 200 ALPHARETTA, GA 30004 | GUARDIAN LIFE INSURANCE COMPANY | $25K | — | $25K | 22.03% |
| REGIONS INSURANCE INC3 Filed as: REGIONS INSURANCE | PO BOX 3198 LITTLE ROCK, AR 72203 | GUARDIAN LIFE INSURANCE COMPANY | $12K | $7K | $19K | 16.84% |
| AI GROUP3 | 12725 MORRIS RD., B.100, STE. 200 ALPHARETTA, GA 30004 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $936 | — | $936 | 14.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 CLAIMS PROCESSOR | Claims processing; Other services Service code 12 | — | $1.4M |
| REGIONS INSURANCE EIN 71-0621654 BROKER | Other commissions Service code 55 | 6000 POPLAR AVE., STE. 300 MEMPHIS, TN 381190928 | $0 |
| THE A.I. GROUP EIN 58-2510431 BROKER | Other commissions Service code 55 | PO BOX 80568 ATHENS, GA 306080568 | $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 | 2,875 | 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) | 2,875 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MCS LIFE INSURANCE COMPANY | 35 | $204K |
| Dental | GUARDIAN LIFE INSURANCE COMPANY | 2,081 | $111K |
| Vision | STANDARD INSURANCE COMPANY | 2,875 | $2.1M |
| Life insurance | STANDARD INSURANCE COMPANY | 2,875 | $2.1M |
| Short-term disability | STANDARD INSURANCE COMPANY | 2,875 | $2.1M |
| Long-term disability | STANDARD INSURANCE COMPANY | 2,875 | $2.1M |
| Stop-loss / reinsurancereinsurance | UNITEDHEALTHCARE INSURANCE COMPANY | 4,873 | $1.6M |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,570 | $6K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,873 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.