| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ARCHIE F LOWE3 | PEACHTREE BENEFIT PARNTERS OF GA 3580 PIERCE DRIVE NE SUITE 100 CHAMBLEE, GA 30341 | UNITEDHEALTHCARE INSURANCE COMPANY | $324 | — | $324 | 0.08% |
| ACRISURE LLC3 | P O BOX 1788 GRAND RAPIDS, MI 49501 | BLUE CROSS AND BLUE SHIELD OF GEORGIA | $12K | $493 | $12K | 10.28% |
| ACRISURE LLC3 | P O BOX 1788 GRAND RAPIDS, MI 49501 | GREATER GEORGIA LIFE INSURANCE COMPANY | $15K | $352 | $15K | 25.31% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES INC EIN 41-1289245 CLAIMS PROCESSOR | Claims processing; Other services Service code 12 | — | $122K |
| ARCHIE F LOWE BROKER | Other commissions Service code 55 | 3580 PIERCE DRIVE NE SUITE 100 CHAMBLEE, GA 30341 | $54K |
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 | 204 | 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) | 204 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 274 | $384K |
| Dental | BLUE CROSS AND BLUE SHIELD OF GEORGIA | 303 | $119K |
| Vision | BLUE CROSS AND BLUE SHIELD OF GEORGIA | 303 | $119K |
| Life insurance | GREATER GEORGIA LIFE INSURANCE COMPANY | 204 | $61K |
| Short-term disability | GREATER GEORGIA LIFE INSURANCE COMPANY | 204 | $61K |
| Long-term disability | GREATER GEORGIA LIFE INSURANCE COMPANY | 204 | $61K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 303 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.