| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PIEDMONT BENEFITS GROUP, INC.3 Filed as: PIEDMONT BENEFITS GROUP LLC | 1040 CROWN POINTE PARKWAY SUITE 545 ATLANTA, GA 30338 | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA | $3K | — | $3K | 0.69% |
| PIEDMONT BENEFITS GROUP, INC.3 Filed as: PIEDMONT BENEFITS GROUP LLC | 1040 CROWN POINTE PARKWAY SUITE 545 ATLANTA, GA 30338 | AETNA LIFE INSURANCE COMPANY | $11K | — | $11K | 5.97% |
| PIEDMONT BENEFITS GROUP, INC.3 Filed as: PIEDMONT BENEFITS GROUP LLC | 1040 CROWN POINTE PKWY SUITE 545 ATLANTA, GA 30338 | AMERICAN UNITED LIFE INSURANCE COMPANY | $20K | — | $20K | 100.00% |
| PATRICIA A HUNT4 | 528 LONGHORN CRES ROCKVILLE, MD 20850 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $1K | — | $1K | 17.61% |
| MARY THERESA FISHER4 | 29C OWNES LANDING COURT PERRYVILLE, MD 21903 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $630 | — | $630 | 10.83% |
| PIEDMONT BENEFITS GROUP, INC.4 Filed as: PIEDMONT BENEFITS GROUP LLC | 1040 CROWN POINTE PKWY SUITE 545 ATLANTA, GA 30338 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $410 | — | $410 | 7.05% |
| CORY WALKER4 | 4606 N LOCUST ST NORTH LITTLE ROCK, AR 72116 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $23 | — | $23 | 0.40% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD HEALTH PL GA EIN 58-1638390 NETWORK PHARM MARGIN | Other services; Other fees; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Contract Administrator Service code 12 | — | $151K |
| PIEDMONT BENEFITS GROUP LLC | Insurance brokerage commissions and fees; Insurance agents and brokers; Other commissions Service code 22 | — | $42K |
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 | 276 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 276 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AETNA LIFE INSURANCE COMPANY | 573 | $178K |
| Vision | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA | 438 | $391K |
| Life insurance | AMERICAN UNITED LIFE INSURANCE COMPANY | 303 | $20K |
| Short-term disability | AMERICAN UNITED LIFE INSURANCE COMPANY | 303 | $20K |
| Long-term disability | AMERICAN UNITED LIFE INSURANCE COMPANY | 303 | $20K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA | 438 | $391K |
| Other(2 contracts, 2 carriers) | AMERICAN UNITED LIFE INSURANCE COMPANY | 303 | $25K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 573 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.