| 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) | $311K | $0 | $311K | 3.25% |
| HAVEN BENEFITS3 | 1000 PEACHTREE INDUSTRIAL BLVD SUWANEE, GA 30024 | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. (G0386) | $69K | $0 | $69K | 3.25% |
| HAVEN BENEFITS3 | 1000 PEACHTREE INDUSTRIAL BLVD SUWANEE, GA 30024 | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. (G0386) | $16K | $0 | $16K | 3.25% |
| HAVEN BENEFITS3 | 1000 PEACHTREE INDUSTRIAL BLVD SUWANEE, GA 30024 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $22K | $0 | $22K | 16.97% |
| COMPSYCH5 | 455 N. CITYFRONT PLAZA DRIVE CHICAGO, IL 606115322 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $2K | $2K | 1.14% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 110 CHICAGO, IL 606036115 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $38 | $38 | 0.03% |
| HAVEN BENEFITS3 | 1000 PEACHTREE INDUSTRIAL BLVD SUWANEE, GA 30024 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $17K | $0 | $17K | 16.97% |
| COMPSYCH5 | 455 N. CITYFRONT PLAZA DRIVE CHICAGO, IL 606115322 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $1K | $1K | 1.14% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 110 CHICAGO, IL 606036115 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $28 | $28 | 0.03% |
| HAVEN BENEFITS3 | 1000 PEACHTREE INDUSTRIAL BLVD SUWANEE, GA 30024 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $16K | $0 | $16K | 16.97% |
| COMPSYCH | 455 N. CITYFRONT PLAZA DRIVE CHICAGO, IL 606115322 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $1K | $1K | 1.14% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 110 CHICAGO, IL 606036115 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $28 | $28 | 0.03% |
| HAVEN BENEFITS3 | 1000 PEACHTREE INDUSTRIAL BLVD SUWANEE, GA 30024 | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. (G0385) | $2K | $0 | $2K | 3.25% |
| HAVEN BENEFITS1 | 1000 PEACHTREE INDUSTRIAL BLVD SUWANEE, GA 30024 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $7K | $0 | $7K | 16.97% |
| COMPSYCH6 | 455 N. CITYFRONT PLAZA DRIVE CHICAGO, IL 606115322 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $495 | $495 | 1.14% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 110 CHICAGO, IL 606036115 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $12 | $12 | 0.03% |
| HAVEN BENEFITS5 | 1000 PEACHTREE INDUSTRIAL BLVD SUWANEE, GA 30024 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 16.97% |
| COMPSYCH1 | 455 N. CITYFRONT PLAZA DRIVE CHICAGO, IL 606115322 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $167 | $167 | 1.15% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 110 CHICAGO, IL 606036115 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $4 | $4 | 0.03% |
| HAVEN BENEFITS3 | 1000 PEACHTREE INDUSTRIAL BLVD SUWANEE, GA 30024 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 16.97% |
| COMPSYCH5 | 455 N. CITYFRONT PLAZA DRIVE CHICAGO, IL 606115322 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $80 | $80 | 1.14% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 110 CHICAGO, IL 606036115 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $2 | $2 | 0.03% |
| HAVEN BENEFITS3 | 1000 PEACHTREE INDUSTRIAL BLVD SUWANEE, GA 30024 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $979 | $0 | $979 | 16.97% |
| COMPSYCH5 | 455 N. CITYFRONT PLAZA DRIVE CHICAGO, IL 606115322 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $66 | $66 | 1.14% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 110 CHICAGO, IL 606036115 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $2 | $2 | 0.03% |
| HAVEN BENEFITS1 | 1000 PEACHTREE INDUSTRIAL BLVD SUIT SUWANEE, GA 30024 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $308 | $0 | $308 | 16.96% |
| COMPSYCH6 | 455 N. CITYFRONT PLAZA DRIVE CHICAGO, IL 606115322 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $21 | $21 | 1.16% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 110 CHICAGO, IL 606036115 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $1 | $1 | 0.06% |
| HAVEN BENEFITS3 | 1000 PEACHTREE INDUSTRIAL BLVD SUWANEE, GA 30024 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $126 | $0 | $126 | 17.00% |
| COMPSYCH5 | 455 N. CITYFRONT PLAZA DRIVE CHICAGO, IL 606115322 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $8 | $8 | 1.08% |
| 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 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $11 | $0 | $11 | 17.46% |
| COMPSYCH5 | 455 N. CITYFRONT PLAZA DRIVE CHICAGO, IL 606115322 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $1 | $1 | 1.59% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 110 CHICAGO, IL 606036115 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $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 | 603 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 124 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 732 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. (G0386) | 1,187 | $11.7M |
| Dental | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. (G0386) | 1,478 | $482K |
| Vision | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. (G0385) | 1,455 | $65K |
| Life insurance(4 contracts) | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,207 | $155K |
| Short-term disability | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,208 | $98K |
| Long-term disability(2 contracts) | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,207 | $175K |
| Other(4 contracts) | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,376 | $14K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,478 | — |
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.