| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| UNIVERSITY FAMILY INSURANCE3 | 1700 WADE HAMPTON BLVD. PO BOX 34625 GREENVILLE, SC 29614 | AMERICAN UNITED LIFE INSURANCE COMPANY | $63K | $8K | $71K | 22.44% |
| EARL L. MITCHELL3 | 101 MCCANLESS ST. CARTERSVILLE, GA 30120 | AMERICAN UNITED LIFE INSURANCE COMPANY | $0 | $10K | $10K | 3.00% |
| EARL L. MITCHELL3 Filed as: EARL LEE MITCHELL | 101 MCCANLESS ST. CARTERSVILLE, GA 301203919 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $19K | — | $19K | 17.48% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PLANNED ADMINISTRATORS, INC. EIN 57-0718839 CONTRACT ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $157K |
| LDI INTEGRATED PHARMACY SERVICES EIN 43-0912223 PBM | Contract Administrator; Claims processing Service code 12 | — | $67K |
| BLUE CROSS BLUE SHIELD OF SC EIN 57-0287419 PPO, UR, AND CM | Insurance services; Other services Service code 23 | — | $0 |
| CERIDIAN EIN 59-3424469 COBRA ADMINISTRATION | Contract Administrator Service code 13 | — | $0 |
| FIRSTHEALTH EIN 20-1736437 PPO NETWORK FEES | Other services Service code 49 | — | $0 |
| HEALTHRISK RESOURCE GROUP, LLC EIN 52-2085838 PPO NETWORK FEES | Other services Service code 49 | — | $0 |
| THE RJC GROUP, LLC EIN 56-1906347 BROKER AND CONSULTANT | Insurance agents and brokers Service code 22 | — | $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 | 839 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 155 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 994 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | AMERICAN UNITED LIFE INSURANCE COMPANY | 591 | $317K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 961 | $111K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 961 | $111K |
| Other | AMERICAN UNITED LIFE INSURANCE COMPANY | 591 | $317K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 961 | — |
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.