| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MIKE DENDY3 | 5352 LACOSTA LANE ALPHARETTA, GA 30022 | HIIG UNDERWRITERS AGENCY INC | $48K | — | $48K | 17.40% |
| CAPSTONE BENEFITS CONSULTING LLC3 Filed as: CAPSTONE BENEFITS CONSULTING INC | 1100 BRAMPTON AVE STE N STATESBORO, GA 30458 | DELTA DENTAL OF TENNESSEE | $9K | $0 | $9K | 10.00% |
| CAPSTONE HIRE BENEFITS CONSULTING3 | 841 BUCKHEAD DRIVE SUITE2 STATESBORO, GA 30458 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $2K | $9K | 20.06% |
| CAPSTONE HIRE BENEFITS CONSULTING3 | 841 BUCKHEAD DRIVE SUITE 2 STATESBORO, GA 30458 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $2K | $8K | 20.42% |
| CAPSTONE HIRE BENEFITS CONSULTING3 | 841 BUCKHEAD DRIVE SUITE 2 STATESBORO, GA 30458 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $1K | $6K | 20.27% |
| CAPSTONE HIRE BENEFITS CONSULTING3 | 841 BUCKHEAD DRIVE SUITE 2 STATESBORO, GA 30458 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $965 | $5K | 24.86% |
| CAPSTONE HIRE BENEFITS CONSULTING3 | 841 BUCKHEAD DRIVE SUITE 2 STATESBORO, GA 30458 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $438 | $3K | 17.65% |
| CAPSTONE HIRE BENEFITS CONSULTING3 | 841 BUCKHEAD DRIVE SUITE 2 STATESBORO, GA 30458 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $697 | $3K | 25.03% |
| CAPSTONE BENEFITS CONSULTING LLC3 | 1100 BRAMPTON AVE SUITE N STATESBORO, GA 30458 | EYEMED VISION CARE OBO FIDELITY SECURITY LIFE INSURANCE COMPANY | $902 | $0 | $902 | 9.12% |
| CAPSTONE HIRE BENEFITS CONSULTING3 | 841 BUCKHEAD DRIVE SUITE 2 STATESBORO, GA 30458 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $398 | $1K | 20.92% |
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 | 220 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 220 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HIIG UNDERWRITERS AGENCY INC | 224 | $276K |
| Dental | DELTA DENTAL OF TENNESSEE | 277 | $88K |
| Vision | EYEMED VISION CARE OBO FIDELITY SECURITY LIFE INSURANCE COMPANY | 278 | $10K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 221 | $28K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 20 | $7K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 221 | $47K |
| Prescription drug | HIIG UNDERWRITERS AGENCY INC | 224 | $276K |
| Stop-loss / reinsurancereinsurance | HIIG UNDERWRITERS AGENCY INC | 224 | $276K |
| Other(5 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 221 | $116K |
| 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.