| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MOULTON AND HARDIN, INC.3 Filed as: MOULTON AND HARDIN INC | PO BOX 2260 ALBANY, GA 31702 | BLUE CROSS BLUE SHIELD OF GEORGIA, INC. | $83K | $0 | $83K | 5.29% |
| MOULTON AND HARDIN, INC.3 Filed as: MOULTON & HARDIN | P.O. BOX 2260 ALBANY, GA 31702 | GREATER GEORGIA LIFE INSURANCE COMPANY | $8K | $0 | $8K | 16.78% |
| MOULTON AND HARDIN, INC.3 Filed as: MOULTON & HARDIN | P.O. BOX 2260 ALBANY, GA 31702 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 6.27% |
| JEM MANAGEMENT3 | P.O. BOX 916 GAINESVILLE, GA 30503 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 6.27% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNUM LIFE INSURANCE COMPANY EIN 01-0278678 STD ADMIN | Claims processing; Contract Administrator Service code 12 | — | $11K |
| JEM MANAGEMENT EIN 58-2576462 BROKER | Insurance agents and brokers Service code 22 | — | $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 | 303 | 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) | 303 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF GEORGIA, INC. | 209 | $1.6M |
| Dental | BLUE CROSS BLUE SHIELD OF GEORGIA, INC. | 209 | $1.6M |
| Vision | BLUE CROSS BLUE SHIELD OF GEORGIA, INC. | 209 | $1.6M |
| Life insurance | GREATER GEORGIA LIFE INSURANCE COMPANY | 303 | $47K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 270 | $29K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF GEORGIA, INC. | 209 | $1.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 303 | — |
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.
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.