| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HEALTHSMART BENEFIT SOLUTIONS5 | P O BOX 167429 IRVING, TX 75016 | HCC LIFE INSURANCE COMPANY | $4K | — | $4K | 1.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTHSMART EIN 75-2960859 NONE | Claims processing; Other fees Service code 12 | — | $442K |
| BLUE CROSS BLUE SHIELD OF GA INC EIN 58-1638390 VENDOR | Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Insurance agents and brokers; Claims processing; Insurance brokerage commissions and fees; Contract Administrator; Other commissions; Other services Service code 12 | — | $68K |
| DELTA DENTAL EIN 31-0685339 VENDOR | Claims processing Service code 12 | — | $61K |
| COMPSYCH EIN 36-3739783 VENDOR | Claims processing Service code 12 | — | $40K |
| HEALTHCARE STRATEGIES EIN 52-1874471 NONE | Other fees Service code 99 | — | $17K |
| CAREMARK EIN 95-3382344 VENDOR | Claims processing Service code 12 | — | $17K |
| MEDCOM EIN 59-2316866 NONE | Other fees Service code 99 | — | $15K |
| FINDLEY DAVIES EIN 31-6585408 NONE | Other fees Service code 99 | — | $10K |
| MAXIM EIN 52-1590951 VENDOR | Other fees Service code 99 | — | $8K |
| SPECTERA EIN 52-1260282 VENDOR | Contract Administrator Service code 13 | — | $7K |
| EMPLOYERS HEALTH PURCHASING GROUP EIN 34-1893487 BROKER | Other commissions Service code 55 | — | $1K |
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 | 1,294 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,294 | Active + retired/separated + beneficiaries. No dependents. |
No Schedule A insurance contracts on this filing — typical of fully self-funded plans, where the only headcount is the Form 5500 number above.
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.