| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | ANTHEM BLUE CROSS BLUE SHIELD | $283K | $3K | $285K | 2.98% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SOUTHERN BENEFIT ADMINISTRATORS EIN 62-1116095 NONE | Consulting (general); Actuarial; Plan Administrator Service code 11 | P.O. BOX 1449 GOODLETTSVILLE, TN 37070 | $155K |
| ARNALL GOLDEN GREGORY EIN 58-0543673 NONE | Legal Service code 29 | 171 17TH ST NW ATLANTA, GA 30363 | $29K |
| DENNIS G. JENKINS, CPA, LLC EIN 20-5886120 NONE | Accounting (including auditing) Service code 10 | 1690 STONE VILLAGE LN 501 KENNESAW, GA 30152 | $12K |
| MUTUAL FUNDS NONE | Custodial (securities); Investment management Service code 19 | — | $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 | 556 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 72 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 628 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM BLUE CROSS BLUE SHIELD | 628 | $9.6M |
| Dental | ANTHEM BLUE CROSS BLUE SHIELD | 628 | $9.6M |
| Vision | ANTHEM BLUE CROSS BLUE SHIELD | 628 | $9.6M |
| Life insurance | GREATER GEORGIA LIFE INSURANCE COMPANY | 628 | $149K |
| Short-term disability | GREATER GEORGIA LIFE INSURANCE COMPANY | 628 | $149K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 628 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.