| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SYNERGY CORPORATE SERVICES, INC.3 Filed as: SYNERGY CORPORATE SERVICE | 267 W WIEUCA ROAD NE SUITE 204 ATLANTA, GA 30342 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 13.15% |
| SYNERGY CORPORATE SERVICES, INC.3 Filed as: SYNERGY CORPORATE SERVICE | 267 W WIEUCA ROAD NE SUITE 204 ATLANTA, GA 30342 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $746 | — | $746 | 13.68% |
| RACHAEL COLLIER3 | 267 W WIEUC ROAD SUITE 204 ATLANTA, GA 30342 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 33.00% |
| THE CASON GROUP INC3 Filed as: THE CASON GROUP | P O BOX 11229 COLUMBIA, SC 29211 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $533 | — | $533 | 15.25% |
| TONYA LANCASTER3 | 1820 THE EXCHANGE SUITE 750 ATLANTA, GA 30339 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $63 | — | $63 | 1.80% |
| SYNERGY CORPORATE SERVICES, INC.3 Filed as: SYNERGY CORPORATE SERVICE | 267 W WIEUCA ROAD NE SUITE 204 ATLANTA, GA 30342 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $367 | — | $367 | 13.78% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SYNERGY CORPORATE SERVICES INC BROKER | Insurance agents and brokers; Insurance services Service code 22 | 267 W WIEUCA ROAD NE SUITE 204 ATLANTA, GA 30342 | $18K |
| CIGNA | Claims processing; Direct payment from the plan; Float revenue; Named fiduciary; Other services; Contract Administrator; Participant communication; Non-monetary compensation Service code 12 | — | $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 | 119 | 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) | 119 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 145 | $141K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 145 | $141K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 145 | $141K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 64 | $3K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 43 | $12K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 48 | $5K |
| Other(2 contracts, 2 carriers) | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 64 | $6K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 145 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.