| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| IMA, INC.3 Filed as: DIVERSIFIED INSURANCE IMA INC CO | 136 E SOUTH TEMPLE #2300 SALT LAKE CITY, UT 84111 | RENAISSANCE LIFE AND HEALTH INSURANCE COMPANY OF AMERICA | $19K | $0 | $19K | 9.95% |
| MELISA LYNN SIZEMORE3 | 6353 CHESTNUT PKWY FLOWERY BRANCH, GA 30542 | AFLAC | $47 | $0 | $47 | 4.50% |
| RICHARD SMITHSON3 Filed as: RICHARD A SMITHSON | 2145 SAULS PL ALPHARETTA, GA 30004 | AFLAC | $21 | $0 | $21 | 2.01% |
| COLLEEN M KIRKLAND3 | 1270 HOPEWELL CRST ALPHARETTA, GA 30004 | AFLAC | $11 | $0 | $11 | 1.05% |
| JUAN ORTS3 Filed as: JUAN C ORTS | 920 FLORAL BANK PT WOODSTOCK, GA 30188 | AFLAC | $4 | $0 | $4 | 0.38% |
| JEFFREY M SINTAY3 | 680 BLACKWELL BND ALPHARETTA, GA 30004 | AFLAC | $1 | $0 | $1 | 0.10% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF GA EIN 58-1638390 CLAIMS PROCESSING | Claims processing; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Contract Administrator Service code 12 | — | $168K |
| BENEFIT CO LLC AGENT | Insurance agents and brokers; Other commissions; Insurance brokerage commissions and fees Service code 22 | 6 CONCOURSE PKWY SUITE 2750 ATLANTA, GA 30328 | $0 |
| IMA INC AGENT | Insurance agents and brokers; Other commissions; Insurance brokerage commissions and fees Service code 22 | 1550 17TH STREET 600 DENVER, CO 80202 | $0 |
| INGENIORX INC EIN 82-3062245 RX MANAGER | Claims processing Service code 12 | — | $0 |
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 | 250 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 250 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | RENAISSANCE LIFE AND HEALTH INSURANCE COMPANY OF AMERICA | 250 | $193K |
| Long-term disability | RENAISSANCE LIFE AND HEALTH INSURANCE COMPANY OF AMERICA | 250 | $193K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | 189 | $690K |
| Other(2 contracts, 2 carriers) | RENAISSANCE LIFE AND HEALTH INSURANCE COMPANY OF AMERICA | 250 | $194K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 250 | — |
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.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.