| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CMA AGENCY3 | 305 GREEN STREET NW GAINESVILLE, GA 30501 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| CMA AGENCY3 | 305 GREEN STREET NW GAINESVILLE, GA 30501 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| CMA AGENCY3 | P O BOX 918 GAINESVILLE, GA 30503 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $1K | — | $1K | 10.02% |
| CMA AGENCY3 | 305 GREEN STREET NW GAINESVILLE, GA 30501 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| CMA AGENCY3 | 305 GREEN STREET NW GAINESVILLE, GA 30501 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | GREATER GEORGIA LIFE INSURANCE COMPANY | $1K | $1K | $3K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENEFIT SUPPORT, INC EIN 58-1644374 | Contract Administrator Service code 13 | P O BOX 2977 GAINESVILLE, GA 30503 | $53K |
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 | 155 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 156 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 189 | $11K |
| Life insurance(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 160 | $34K |
| Short-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 159 | $11K |
| Long-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 160 | $16K |
| Stop-loss / reinsurancereinsurance | NATIONAL UNDERWRITING SERVICES, INC. | 150 | $308K |
| Other | GREATER GEORGIA LIFE INSURANCE COMPANY | 1 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 189 | — |
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.