| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | $141K | $12K | $153K | 4.37% |
| ACRISURE LLC3 | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | GREATER GEORGIA LIFE INSURANCE COMPANY | $15K | $884 | $16K | 9.58% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA PEACHTREE BENEFIT | 3580 PIERCE DRIVE STE 100 CHAMBLEE, GA 30341 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 10.00% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA PEACHTREE BENEFIT | 3580 PIERCE DRIVE STE 100 CHAMBLEE, GA 30341 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 10.00% |
| ACRISURE LLC3 | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | GREATER GEORGIA LIFE INSURANCE COMPANY | $955 | $54 | $1K | 10.65% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA PEACHTREE BENEFIT | 3580 PIERCE DRIVE STE 100 CHAMBLEE, GA 30341 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $818 | — | $818 | 10.00% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA PEACHTREE BENEFIT | 3580 PIERCE DRIVE STE 100 CHAMBLEE, GA 30341 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $335 | — | $335 | 10.01% |
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 | 377 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 377 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | 719 | $3.5M |
| Dental | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | 719 | $3.5M |
| Vision | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | 719 | $3.5M |
| Life insurance(3 contracts, 2 carriers) | GREATER GEORGIA LIFE INSURANCE COMPANY | 526 | $195K |
| Short-term disability(2 contracts, 2 carriers) | GREATER GEORGIA LIFE INSURANCE COMPANY | 330 | $179K |
| Long-term disability(2 contracts, 2 carriers) | GREATER GEORGIA LIFE INSURANCE COMPANY | 330 | $175K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 526 | $3K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 719 | — |
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.