| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 45263 | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. | $37K | — | $37K | 63.62% |
| THE BENEFIT COMPANY INC3 Filed as: THE BENEFIT COMPANY LLC | SIX CONCOURSE PARKWAY SUITE 2750 ATLANTA, GA 30328 | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. | $18K | — | $18K | 30.08% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 45263 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $900 | — | $900 | 9.03% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SVS INC | PO BOX 632886 CINCINNATI, OH 45263 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 147.31% |
| THE BENEFIT COMPANY INC3 Filed as: BENEFIT COMPANY LLC | SIX CONCOURSE PARKWAY SUITE 2750 ATLANTA, GA 30328 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 57.18% |
| AXA ASSISTANCE, USA3 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $46 | $46 | 0.75% |
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 | 121 | 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) | 122 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | 127 | $1.3M |
| Dental | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. | 112 | $59K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 162 | $10K |
| Life insurance(2 contracts) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 128 | $71K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 128 | $65K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 128 | $65K |
| Prescription drug | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | 127 | $1.3M |
| Other(2 contracts) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 128 | $71K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 162 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.