| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| REGIONS INSURANCE INC3 Filed as: REGIONS INSURANCE INC. | 6000 POPLAR AVE STE 300 MEMPHIS, TN 38119 | KAISER FOUNDATION HEALTH PLAN INC. | $30K | $0 | $30K | 1.75% |
| THE A.I. GROUP INC3 Filed as: THE A I GROUP, INC. | PO BOX 80568 ATHENS, GA 30608 | KAISER FOUNDATION HEALTH PLAN INC. | $9K | $0 | $9K | 0.51% |
| DANIEL J. MURPHY3 Filed as: DANIEL MURPHY | 12725 MORRIS RD. EXT STE 200 ALPHARETTA, GA 30004 | THE STANDARD LIFE INSURANCE CO. OF NEW YORK | $15K | — | $15K | 3.20% |
| REGIONS INSURANCE INC3 Filed as: REGIONS INSURANCE INC. | 405 E ST. PETER STREET NEW IBERIA, LA 70560 | THE STANDARD LIFE INSURANCE CO. OF NEW YORK | $6K | — | $6K | 1.19% |
| REGIONS INSURANCE INC3 Filed as: REGIONS INSURANCE INC. | PO BOX 80568 ATHENS, GA 30608 | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | $12K | — | $12K | 35.00% |
| REGIONS INSURANCE INC3 Filed as: REGIONS INSURANCE INC. | PO BOX 3198 LITTLE ROCK, AR 72203 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $10K | — | $10K | 33.50% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 CLAIMS PROCESSOR | Other services; Claims processing Service code 12 | 5901 LINCOLN DR. MINNEAPOLIS, MN 55436 | $527K |
| AI GROUP EIN 58-2510431 BROKER | Other commissions Service code 55 | 12725 MORRIS ROAD EXT ALPHARETTA, GA 30004 | $0 |
| REGIONS INSURANCE EIN 71-0621654 BROKER | Other commissions Service code 55 | 6000 POPLAR AVE STE 300 MEMPHIS, TN 38119 | $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 | 1,264 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,273 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 217 | $1.7M |
| Dental(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 841 | $231K |
| Vision | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | 949 | $33K |
| Life insurance | THE STANDARD LIFE INSURANCE CO. OF NEW YORK | 1,037 | $482K |
| Short-term disability | THE STANDARD LIFE INSURANCE CO. OF NEW YORK | 1,037 | $482K |
| Long-term disability | THE STANDARD LIFE INSURANCE CO. OF NEW YORK | 1,037 | $482K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,037 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.