| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INSURANCE OFFICE OF AMERICA3 | 2839 PACES FERRY ROAD SUITE 1200 ATLANTA, GA 30339 | COMPANION LIFE INSURANCE COMPANY | $4K | — | $4K | 3.00% |
| INSURANCE OFFICE OF AMERICA3 | 2839 PACES FERRY ROAD SUITE 1200 ATLANTA, GA 30339 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $6K | — | $6K | 13.71% |
| WELLS FARGO INSURANCE SERVICES3 | 3475 PIEDMONT ROAD NE SUITE 800 ATLANTA, GA 30305 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $606 | $202 | $808 | 1.72% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF GEORGIA EIN 58-0469845 ADMINISTRATOR | Recordkeeping and information management (computing, tabulating, data processing, etc.); Other fees; Claims processing; Contract Administrator; Float revenue; Other services Service code 12 | — | $261K |
| BLUE CROSS AND BLUE SHIELD OF GA | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Claims processing; Float revenue Service code 12 | — | $113K |
| WELLS FARGO INS SERVICES USA | Other commissions; Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | — | $25K |
| INSURANCE OFFICE OF AMERICA INC | Insurance brokerage commissions and fees; Insurance agents and brokers; Other commissions Service code 22 | — | $14K |
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 | 344 | 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) | 344 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 344 | $184K |
| Long-term disability(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 344 | $208K |
| Stop-loss / reinsurancereinsurance | COMPANION LIFE INSURANCE COMPANY | 305 | $149K |
| Other(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 344 | $184K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 344 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.