| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS. SERVICES USA INC. | PO BOX 203991 DALLAS, TX 75320 | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA,INC.(G0386) | $56K | — | $56K | 0.85% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS. SERVICES USA INC. | PO BOX 203991 DALLAS, TX 75320 | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. (G0385) | $2K | — | $2K | 0.85% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 3475 PIEDMONT RD. NE STE 800 ATLANTA, GA 30305 | GREATER GEORGIA LIFE INSURANCE COMPANY | $2K | — | $2K | 12.38% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| GEORGIA DENTAL INSURANCE SERVICES EIN 58-2329489 RELATED PARTY | Plan Administrator Service code 14 | — | $201K |
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 | 586 | Currently employed and enrolled or eligible. |
| Retired/separated still eligible | 5 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 591 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA,INC.(G0386) | 1,100 | $6.9M |
| Vision | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. (G0385) | 313 | $286K |
| Life insurance | GREATER GEORGIA LIFE INSURANCE COMPANY | 591 | $13K |
| Other | GREATER GEORGIA LIFE INSURANCE COMPANY | 591 | $13K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,100 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.