| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CAPITOL SPECIAL RISKS | 1899 POWERS FERRY RD., SUITE 100 ATLANTA, GA 30339 | TRANSAMERICAN LIFE FORMERLY WESTERN RESERVE | $21K | — | $21K | 9.00% |
| INTERACTIVE INSURANCE SOLUTIONS | 729 RAGSDALE ROAD SHARPSBURG, GA 30277 | TRANSAMERICAN LIFE FORMERLY WESTERN RESERVE | $2K | — | $2K | 1.00% |
| CAPITOL SPECIAL RISKS | 1000 PARKWOOD CIRCLE, SUITE 925 ATLANTA, GA 30339 | TRANSAMERICAN LIFE FORMERLY WESTERN RESERVE | $6K | — | $6K | 9.00% |
| INTERACTIVE INSURANCE SOLUTIONS | 729 RAGSDALE ROAD SHARPSBURG, GA 30277 | TRANSAMERICAN LIFE FORMERLY WESTERN RESERVE | $672 | — | $672 | 1.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENEFIT PLAN ADMINISTRATION EIN 39-1400101 NONE | Plan Administrator; Direct payment from the plan Service code 14 | — | $230K |
| UNITED HEALTHCARE INSURANCE COMPANY EIN 36-2739571 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $209K |
| LEE JOST & ASSOCIATES EIN 39-1400101 NONE | Direct payment from the plan; Actuarial; Consulting (general) Service code 11 | — | $46K |
| BMO HARRIS FINANCIAL GROUP EIN 36-2085229 NONE | Investment management fees paid directly by plan; Direct payment from the plan; Trustee (bank, trust company, or similar financial institution); Investment management Service code 21 | — | $24K |
| FREYBERG HINKLE ET AL EIN 39-1531945 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $16K |
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 | 390 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 130 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 520 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance(2 contracts) | TRANSAMERICAN LIFE FORMERLY WESTERN RESERVE | 386 | $305K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 386 | — |
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.