| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CMA AGENCY3 Filed as: CMA AGENCY, INC. | 305 GREEN STREET NW GAINESVILLE, GA 30501 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| CMA AGENCY3 Filed as: CMA AGENCY, INC. | 305 GREEN STREET NW GAINESVILLE, GA 30501 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| CMA AGENCY3 Filed as: CMA AGENCY, INC. | P O BOX 918 GAINESVILLE, GA 30503 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $1K | — | $1K | 9.95% |
| CMA AGENCY3 Filed as: CMA AGENCY, INC. | 305 GREEN STREET NW GAINESVILLE, GA 30501 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| CMA AGENCY3 Filed as: CMA AGENCY, INC. | 305 GREEN STREET NW GAINESVILLE, GA 30501 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $987 | — | $987 | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENEFIT SUPPORT, INC. EIN 58-1644374 | Contract Administrator Service code 13 | P O BOX 2977 GAINESVILLE, GA 30503 | $50K |
| CMA AGENCY, INC. EIN 58-2094944 | Insurance agents and brokers Service code 22 | P O BOX 918 GAINESVILLE, GA 30503 | $46K |
| CHAR LEE CORPORATION DBA MANAGED CA EIN 86-0799129 | Other services Service code 49 | 1539 STRICKLAND AVENUE SUITE A ORANGE, TX 77630 | $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 | 149 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 150 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | NATIONAL UNDERWRITING SERVICES, INC. | 148 | $285K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 112 | $13K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 156 | $34K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 153 | $10K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 155 | $15K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 156 | — |
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."
No prospect flags tripped on this filing.