| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CAPITOL SPECIAL RISKS | 1000 PARKWOOD CIRCLE, SUITE 925 ATLANTA, GA 30339 | TRANSAMERICAN LIFE FORMERLY WESTERN RESERVE | — | — | $0 | 0.00% |
| INTERACTIVE INSURANCE SOLUTIONS | 729 RAGSDALE ROAD SHARPSBURG, GA 30277 | TRANSAMERICAN LIFE FORMERLY WESTERN RESERVE | — | — | $0 | 0.00% |
| CAPITOL SPECIAL RISKS | 1000 PARKWOOD CIRCLE, SUITE 925 ATLANTA, GA 30339 | TRANSAMERICA LIFE | $7K | — | $7K | 9.00% |
| INTERACTIVE INSURANCE SOLUTIONS | 729 RAGSDALE ROAD SHARPSBURG, GA 30277 | TRANSAMERICA LIFE | $817 | — | $817 | 1.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENEFIT PLAN ADMINISTRATION EIN 39-1400101 NONE | Direct payment from the plan; Plan Administrator Service code 14 | — | $251K |
| UNITED HEALTHCARE INSURANCE COMPANY EIN 36-2739571 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $237K |
| ZELIS HEALTHCARE EIN 86-1040704 NONE | Direct payment from the plan; Claims processing; Other fees Service code 12 | — | $95K |
| GLOBALCARE INC. EIN 87-0609325 NONE | Other fees; Claims processing; Direct payment from the plan Service code 12 | — | $82K |
| UMR EIN 36-2739571 NONE | Other fees; Contract Administrator; Direct payment from the plan Service code 13 | — | $69K |
| LEE JOST & ASSOCIATES EIN 39-1400101 NONE | Actuarial; Direct payment from the plan; Consulting (general) Service code 11 | — | $52K |
| BMO HARRIS FINANCIAL GROUP EIN 36-2085229 NONE | Investment management; Direct payment from the plan; Trustee (bank, trust company, or similar financial institution); Investment management fees paid directly by plan Service code 21 | — | $20K |
| FREYBERG HINKLE ET AL EIN 39-1531945 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $16K |
| HAWKES QUINDEL, SC EIN 39-2024202 NONE | Other fees; Legal Service code 29 | — | $7K |
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 | 399 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 131 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 530 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | TRANSAMERICAN LIFE FORMERLY WESTERN RESERVE | 411 | $379K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 411 | — |
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."
No prospect flags tripped on this filing.