| 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) | $357K | — | $357K | 3.34% |
| HAVEN BENEFITS3 | 1000 PEACHTREE INDUSTRIAL BLVD SUWANEE, GA 30024 | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. (G0386) | $90K | — | $90K | 3.34% |
| HAVEN BENEFITS3 | 1000 PEACHTREE INDUSTRIAL BLVD SUWANEE, GA 30024 | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. (G0386) | $18K | — | $18K | 3.34% |
| HAVEN BENEFITS3 | 1000 PEACHTREE INDUSTRIAL BLVD SUWANEE, GA 30024 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $25K | — | $25K | 14.99% |
| COMPSYCH5 | 455 N. CITYFRONT PLAZA DRIVE CHICAGO, IL 606115322 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $2K | $2K | 1.09% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $46 | $46 | 0.03% |
| HAVEN BENEFITS3 | 1000 PEACHTREE INDUSTRIAL BLVD SUWANEE, GA 30024 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $19K | — | $19K | 14.99% |
| COMPSYCH5 | 455 N. CITYFRONT PLAZA DRIVE CHICAGO, IL 606115322 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $1K | $1K | 1.09% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $34 | $34 | 0.03% |
| HAVEN BENEFITS3 | 1000 PEACHTREE INDUSTRIAL BLVD SUWANEE, GA 30024 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $16K | — | $16K | 14.99% |
| COMPSYCH | 455 N. CITYFRONT PLAZA DRIVE CHICAGO, IL 606115322 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $1K | $1K | 1.09% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $30 | $30 | 0.03% |
| HAVEN BENEFITS3 | 1000 PEACHTREE INDUSTRIAL BLVD SUWANEE, GA 30024 | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. (G0385) | $2K | — | $2K | 3.34% |
| HAVEN BENEFITS1 | 1000 PEACHTREE INDUSTRIAL BLVD SUWANEE, GA 30024 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 14.99% |
| COMPSYCH6 | 455 N. CITYFRONT PLAZA DRIVE CHICAGO, IL 606115322 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $584 | $584 | 1.09% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $15 | $15 | 0.03% |
| HAVEN BENEFITS5 | 1000 PEACHTREE INDUSTRIAL BLVD SUWANEE, GA 30024 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 14.99% |
| COMPSYCH1 | 455 N. CITYFRONT PLAZA DRIVE CHICAGO, IL 606115322 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $168 | $168 | 1.09% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $4 | $4 | 0.03% |
| HAVEN BENEFITS3 | 1000 PEACHTREE INDUSTRIAL BLVD SUWANEE, GA 30024 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 14.99% |
| COMPSYCH5 | 455 N. CITYFRONT PLAZA DRIVE CHICAGO, IL 606115322 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $83 | $83 | 1.09% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $2 | $2 | 0.03% |
| HAVEN BENEFITS3 | 1000 PEACHTREE INDUSTRIAL BLVD SUWANEE, GA 30024 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 14.98% |
| COMPSYCH5 | 455 N. CITYFRONT PLAZA DRIVE CHICAGO, IL 606115322 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $78 | $78 | 1.09% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $2 | $2 | 0.03% |
| HAVEN BENEFITS1 | 1000 PEACHTREE INDUSTRIAL BLVD SUIT SUWANEE, GA 30024 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $330 | — | $330 | 14.97% |
| COMPSYCH6 | 455 N. CITYFRONT PLAZA DRIVE CHICAGO, IL 606115322 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $24 | $24 | 1.09% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $1 | $1 | 0.05% |
| HAVEN BENEFITS3 | 1000 PEACHTREE INDUSTRIAL BLVD SUWANEE, GA 30024 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $62 | — | $62 | 14.87% |
| COMPSYCH5 | 455 N. CITYFRONT PLAZA DRIVE CHICAGO, IL 606115322 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $5 | $5 | 1.20% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $0 | $0 | 0.00% |
| HAVEN BENEFITS3 | 1000 PEACHTREE INDUSTRIAL BLVD SUWANEE, GA 30024 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $5 | — | $5 | 13.89% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $0 | $0 | 0.00% |
| COMPSYCH5 | 455 N. CITYFRONT PLAZA DRIVE CHICAGO, IL 606115322 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $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 | 662 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 91 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 753 | 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) | 1,213 | $13.4M |
| Dental | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. (G0386) | 1,543 | $537K |
| Vision | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. (G0385) | 1,529 | $72K |
| Life insurance(4 contracts) | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 687 | $180K |
| Short-term disability | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 684 | $125K |
| Long-term disability(2 contracts) | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 687 | $222K |
| Other(4 contracts) | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 710 | $15K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,543 | — |
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.