| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MICHAEL W RATLIFF3 | P.O. BOX 1617 PERRY, GA 31069 | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. | $14K | — | $14K | 9.79% |
| MICHAEL W RATLIFF3 | PO BOX 1617 PERRY, GA 31069 | MADISON NATIONAL LIFE INSURANCE COMPANY | $23K | — | $23K | 17.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: TIS INSURANCE SERVICES INC | 1900 WINSTON ROAD SUITE 100 KNOXVILLE, TN 37919 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $6K | $1K | $7K | 23.95% |
| NATIONAL BENEFIT CENTER3 Filed as: NATIONAL BENEFIT CENTER LLC | 1105 NORTH MARKET STREET SUITE 1300 WILMINGTON, DE 19801 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $50 | — | $50 | 0.17% |
| MICHAEL W RATLIFF3 | PO BOX 1617 PERRY, GA 31069 | KANSAS CITY LIFE INSURANCE COMPANY | $227 | — | $227 | 7.99% |
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 | 304 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 306 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. | 293 | $141K |
| Vision | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. | 293 | $141K |
| Life insurance(2 contracts, 2 carriers) | MADISON NATIONAL LIFE INSURANCE COMPANY | 491 | $185K |
| Short-term disability | MADISON NATIONAL LIFE INSURANCE COMPANY | 265 | $137K |
| Long-term disability | MADISON NATIONAL LIFE INSURANCE COMPANY | 265 | $137K |
| Stop-loss / reinsurancereinsurance | NATIONWIDE LIFE INSURANCE COMPANY | 154 | $611K |
| Other(4 contracts, 4 carriers) | MADISON NATIONAL LIFE INSURANCE COMPANY | 491 | $218K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 491 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.