| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAVEN BENEFITS3 | 1000 PEACHTREE INDUSTRIAL BLVD SUWANEE, GA 30024 | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. (G0386) | $179K | $0 | $179K | 3.86% |
| HAVEN BENEFITS3 | 1000 PEACHTREE INDUSTRIAL BLVD SUWANEE, GA 30024 | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. (G0386) | $47K | $0 | $47K | 3.86% |
| HAVEN BENEFITS3 | 1000 PEACHTREE INDUSTRIAL BLVD SUWANEE, GA 30024 | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. | $13K | $0 | $13K | 5.00% |
| HAVEN BENEFITS3 | 1000 PEACHTREE INDUSTRIAL BLVD SUWANEE, GA 30024 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $9K | $0 | $9K | 15.00% |
| COMPSYCH5 | 455 N. CITYFRONT PLAZA DRIVE CHICAGO, IL 606115322 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $933 | $933 | 1.57% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 110 CHICAGO, IL 606036115 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $43 | $43 | 0.07% |
| HAVEN BENEFITS3 | 1000 PEACHTREE INDUSTRIAL BLVD SUWANEE, GA 30024 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $8K | $0 | $8K | 15.00% |
| COMPSYCH5 | 455 N. CITYFRONT PLAZA DRIVE CHICAGO, IL 606115322 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $874 | $874 | 1.57% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 110 CHICAGO, IL 606036115 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $40 | $40 | 0.07% |
| HAVEN BENEFITS3 | 1000 PEACHTREE INDUSTRIAL BLVD SUWANEE, GA 30024 | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. (G0385) | $2K | $0 | $2K | 3.85% |
| HAVEN BENEFITS3 | 1000 PEACHTREE INDUSTRIAL BLVD SUWANEE, GA 30024 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $6K | $0 | $6K | 15.00% |
| COMPSYCH5 | 455 N. CITYFRONT PLAZA DRIVE CHICAGO, IL 606115322 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $666 | $666 | 1.57% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 110 CHICAGO, IL 606036115 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $31 | $31 | 0.07% |
| HAVEN BENEFITS3 | 1000 PEACHTREE INDUSTRIAL BLVD SUWANEE, GA 30024 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $4K | $0 | $4K | 15.00% |
| COMPSYCH5 | 455 N. CITYFRONT PLAZA DRIVE CHICAGO, IL 606115322 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $422 | $422 | 1.57% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 110 CHICAGO, IL 606036115 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $19 | $19 | 0.07% |
| HAVEN BENEFITS3 | 1000 PEACHTREE INDUSTRIAL BLVD SUWANEE, GA 30024 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 15.00% |
| COMPSYCH5 | 455 N. CITYFRONT PLAZA DRIVE CHICAGO, IL 606115322 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $163 | $163 | 1.57% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 110 CHICAGO, IL 606036115 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $8 | $8 | 0.08% |
| HAVEN BENEFITS3 | 1000 PEACHTREE INDUSTRIAL BLVD SUIT SUWANEE, GA 30024 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $727 | $0 | $727 | 15.01% |
| COMPSYCH5 | 455 N. CITYFRONT PLAZA DRIVE CHICAGO, IL 606115322 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $76 | $76 | 1.57% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 110 CHICAGO, IL 606036115 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $4 | $4 | 0.08% |
| HAVEN BENEFITS3 | 1000 PEACHTREE INDUSTRIAL BLVD SUWANEE, GA 30024 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $537 | $0 | $537 | 15.01% |
| COMPSYCH5 | 455 N. CITYFRONT PLAZA DRIVE CHICAGO, IL 606115322 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $56 | $56 | 1.57% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 110 CHICAGO, IL 606036115 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $3 | $3 | 0.08% |
| HAVEN BENEFITS3 | 1000 PEACHTREE INDUSTRIAL BLVD SUWANEE, GA 30024 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $190 | $0 | $190 | 14.96% |
| COMPSYCH5 | 455 N. CITYFRONT PLAZA DRIVE CHICAGO, IL 606115322 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $20 | $20 | 1.57% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 110 CHICAGO, IL 606036115 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $1 | $1 | 0.08% |
| HAVEN BENEFITS3 | 1000 PEACHTREE INDUSTRIAL BLVD SUWANEE, GA 30024 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $11 | $0 | $11 | 15.28% |
| COMPSYCH5 | 455 N. CITYFRONT PLAZA DRIVE CHICAGO, IL 606115322 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $1 | $1 | 1.39% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 110 CHICAGO, IL 606036115 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $0 | $0 | 0.00% |
| HAVEN BENEFITS3 | 1000 PEACHTREE INDUSTRIAL BLVD SUWANEE, GA 30024 | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. (G0385) | $0 | $0 | $0 | 0.00% |
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 | 443 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 445 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. (G0386) | 862 | $5.9M |
| Dental | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. | 454 | $269K |
| Vision | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. (G0385) | 1,070 | $49K |
| Life insurance(4 contracts) | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 847 | $94K |
| Short-term disability | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 847 | $42K |
| Long-term disability | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 847 | $59K |
| Other(3 contracts) | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,071 | $8K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,071 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.