| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INSURANCE OFFICE OF AMERICA3 | 2839 PACES FERRY RD, STE 1200 ATLANTA, GA 30339 | COMPANION LIFE INSURANCE COMPANY | $52K | — | $52K | 14.92% |
| INSURANCE OFFICE OF AMERICA3 | 1855 W STATE RD 434 LONGWOOD, FL 327505069 | METROPOLITAN LIFE INSURANCE COMPANY | $35K | $59 | $35K | 10.55% |
| BENETEK CORPORATION3 | 4725 W SAND LAKE ROAD STE 300 ORLANDO, FL 328199510 | METROPOLITAN LIFE INSURANCE COMPANY | — | $9K | $9K | 2.75% |
| INSURANCE OFFICE OF AMERICA3 | 1855 W STATE RD 434 LONGWOOD, FL 327505069 | METROPOLITAN LIFE INSURANCE COMPANY | — | $2K | $2K | 0.47% |
| VOLUNTARY BENEFITS AT WORK3 | 1820 THE EXCHANGE SE - SUITE 750 ATLANTA, GA 30339 | TRUSTMARK INSURANCE COMPANY | $5K | — | $5K | 8.98% |
| INSURANCE OFFICE OF AMERICA3 | 100 GALLERIA PARKWAY - SUITE 600 ATLANTA, GA 30339 | TRUSTMARK INSURANCE COMPANY | $3K | — | $3K | 4.81% |
| INSURANCE OFFICE OF AMERICA3 | 100 GALLERIA PARKWAY - SUITE 600 ATLANTA, GA 30339 | TRUSTMARK INSURANCE COMPANY | $2K | — | $2K | 4.19% |
| BRIAN D ELY3 | 2121 NEWMARKET PKWY SE - SUITE 600 MARIETTA, GA 30067 | TRUSTMARK INSURANCE COMPANY | $9 | — | $9 | 0.02% |
| BRIAN D ELY3 | 1820 THE EXCHANGE SE - SUITE 750 ATLANTA, GA 30339 | CONTINENTAL AMERICAN INSURANCE COMPANY | $5K | — | $5K | 9.26% |
| INSURANCE OFFICE OF AMERICA3 | 1855 W STATE RD 434 LONGWOOD, FL 32750 | CONTINENTAL AMERICAN INSURANCE COMPANY | $5K | — | $5K | 9.26% |
| VOLUNTARY BENEFITS AT WORK3 | 1820 THE EXCHANGE SE - SUITE 750 ATLANTA, GA 30339 | TRUSTMARK INSURANCE COMPANY | $5K | — | $5K | 10.79% |
| INSURANCE OFFICE OF AMERICA3 | 100 GALLERIA PARKWAY - SUITE 600 ATLANTA, GA 30339 | TRUSTMARK INSURANCE COMPANY | $3K | — | $3K | 6.06% |
| INSURANCE OFFICE OF AMERICA3 | 100 GALLERIA PARKWAY - SUITE 600 ATLANTA, GA 30339 | TRUSTMARK INSURANCE COMPANY | $2K | — | $2K | 4.76% |
| BRIAN D ELY3 | 2121 NEWMARKET PKWY SE - SUITE 600 MARIETTA, GA 30067 | TRUSTMARK INSURANCE COMPANY | $14 | — | $14 | 0.03% |
| VOLUNTARY BENEFITS AT WORK3 | 1820 THE EXCHANGE SE - SUITE 750 ATLANTA, GA 30339 | TRUSTMARK INSURANCE COMPANY | $5K | — | $5K | 11.51% |
| INSURANCE OFFICE OF AMERICA3 | 100 GALLERIA PARKWAY - SUITE 600 ATLANTA, GA 30339 | TRUSTMARK INSURANCE COMPANY | $4K | — | $4K | 7.91% |
| INSURANCE OFFICE OF AMERICA3 | 100 GALLERIA PARKWAY - SUITE 600 ATLANTA, GA 30339 | TRUSTMARK INSURANCE COMPANY | $2K | — | $2K | 3.60% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD HEALTHCARE EIN 58-1638390 | Claims processing; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Contract Administrator Service code 12 | — | $301K |
| TRUSTMARK HEALTH BENEFITS, INC. EIN 35-1846036 | Other services; Claims processing; Plan Administrator Service code 12 | — | $115K |
| ANTHEM EIN 95-4331852 | Claims processing; Other services Service code 12 | — | $95K |
| INSURANCE OFFICE OF AMERICA INC EIN 59-2472656 | Insurance agents and brokers; Consulting (general) Service code 16 | — | $54K |
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 | 370 | 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) | 370 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CONTINENTAL AMERICAN INSURANCE COMPANY | 250 | $102K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 892 | $334K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 892 | $334K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 892 | $380K |
| Short-term disability | TRUSTMARK INSURANCE COMPANY | 133 | $58K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 892 | $334K |
| Stop-loss / reinsurancereinsurance | COMPANION LIFE INSURANCE COMPANY | 371 | $349K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 892 | $334K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 892 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.