| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTEGRO INSURANCE BROKERS3 Filed as: INTEGRO USA INC. | 200 GLENRIDGE POINT PKWY., STE. 400 ATLANTA, GA 30342 | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | $89K | — | $89K | 4.01% |
| INTEGRO INSURANCE BROKERS3 Filed as: INTEGRO USA INC. | P.O. BOX 6180 CAROL STREAM, IL 60197 | METROPOLITAN LIFE INSURANCE COMPANY | $15K | $805 | $16K | 7.38% |
| INTEGRO INSURANCE BROKERS3 Filed as: INTEGRO USA INC. | P.O. BOX 6180 CAROL STREAM, IL 60197 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $20K | — | $20K | 12.63% |
| AXA ASSISTANCE, USA3 | 122 S. MICHIGAN AVENUE, SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $75 | $75 | 0.05% |
| CLEARVIEW GROUP3 | P.O. BOX 6180 CAROL STREAM, IL 60197 | FIDELITY SECURITY LIFE INSURANCE COMPANY (EYEMED VISION CARE) | $967 | — | $967 | 9.32% |
| INTEGRO INSURANCE BROKERS3 Filed as: INTEGRO USA INC. | 200 GLENRIDGE POINT PKWY., STE. 400 ATLANTA, GA 30342 | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. | $120 | — | $120 | 4.00% |
No Schedule C service providers reported on this filing.
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 | 271 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 274 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | 395 | $2.2M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 593 | $212K |
| Vision(2 contracts, 2 carriers) | FIDELITY SECURITY LIFE INSURANCE COMPANY (EYEMED VISION CARE) | 248 | $13K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 271 | $156K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 271 | $156K |
| Prescription drug | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | 395 | $2.2M |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 271 | $161K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 593 | — |
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.