| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CHAMPION BENEFITS3 Filed as: CHAMPION BENEFITS APPROACH INC. | 1455 LINCOLN PARKWAY, SUITE 100 ATLANTA, GA 30346 | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | $68K | — | $68K | 9.44% |
| CHAMPION BENEFITS3 Filed as: CHAMPION BENEFITS APPROACH INC. | 1455 LINCOLN PARKWAY, SUITE 100 ATLANTA, GA 30346 | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. | $3K | — | $3K | 5.00% |
| CHAMPION BENEFITS3 Filed as: CHAMPION BENEFITS APPROACH INC. | 1455 LINCOLN PARKWAY, SUITE 100 ATLANTA, GA 30346 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $32 | $6K | 17.42% |
| CHAMPION BENEFITS3 Filed as: CHAMPION BENEFITS APPROACH INC. | 1455 LINCOLN PARKWAY, SUITE 100 ATLANTA, GA 30346 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $831 | — | $831 | 9.73% |
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 | 168 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 169 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | 278 | $722K |
| Dental | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. | 142 | $59K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 167 | $9K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 167 | $36K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 167 | $36K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 167 | $36K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 167 | $36K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 278 | — |
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.