| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PEACHTREE BENEFIT GROUP INC3 | 3580 PIERCE DRIVE SUITE 100 CHAMBLEE, GA 30342 | BLUE CROSS AND BLUE SHIELD OF GEORGIA INC | $1K | — | $1K | 0.79% |
| ACRISURE LLC3 | 5665 PRAIRIE CREEK DRIVE CALEDONIA, MI 49316 | BLUE CROSS AND BLUE SHIELD OF GEORGIA INC | $752 | — | $752 | 0.42% |
| PEACHTREE BENEFIT GROUP INC3 Filed as: PEACHTREE BENEFIT PARTNERS OF GA | 3580 PIERCE DRIVE SUITE 100 ATLANTA, GA 30341 | GREATER GEORGIA LIE INSURANCE COMPANY | $23K | $6K | $28K | 17.03% |
| PEACHTREE BENEFIT GROUP INC3 Filed as: PEACHTREE BENEFIT GROUP | 3580 PIERCE DRIVE SUITE 100 CHAMBLEE, GA 30341 | AETNA LIFE INSURANCE COMPANY | $22K | — | $22K | 13.42% |
| PEACHTREE BENEFIT GROUP INC3 | 3580 PIERCE DRIVE SUITE 100 ATLANTA, GA 30341 | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA INC | — | $889 | $889 | 4.45% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD HEALTHCARE G EIN 58-1638390 ADMIN SVCES | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Other services; Claims processing; Float revenue Service code 12 | — | $532K |
| BLUE CROSS BLUE SHIELD HEALTHCARE | Float revenue; Claims processing; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $78K |
| ACRISURE LLC | Insurance agents and brokers; Insurance brokerage commissions and fees; Other commissions Service code 22 | — | $43K |
| PEACHTREE BENEFIT GROUP INC | Insurance brokerage commissions and fees; Other commissions; Insurance agents and brokers Service code 22 | — | $42K |
| BLUE CROSS AND BLUE SHIELD OF GEORG EIN 58-0469845 ADMIN SERVICES | Claims processing; Contract Administrator; Float revenue; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $40K |
| BLUE CROSS BLUE SHIELD GA INC EIN 58-0469845 NETWORK PH MGN | Other fees Service code 99 | — | $18K |
| ANTHEM LIFE INSURANCE COMPANY EIN 35-0980405 CLAIMS ADMIN | Float revenue; Claims processing; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 12 | — | $6K |
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 | 406 | 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) | 406 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF GEORGIA INC | 621 | $179K |
| Vision | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA INC | 638 | $20K |
| Life insurance | AETNA LIFE INSURANCE COMPANY | 459 | $164K |
| Short-term disability(2 contracts, 2 carriers) | GREATER GEORGIA LIE INSURANCE COMPANY | 638 | $186K |
| Long-term disability(2 contracts, 2 carriers) | GREATER GEORGIA LIE INSURANCE COMPANY | 638 | $186K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS AND BLUE SHIELD OF GEORGIA INC | 621 | $179K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 638 | — |
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.