| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CHAMPION BENEFITS3 | 1455 LINCOLN PARKWAY, SUITE 100 ATLANTA, GA 30346 | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | $14K | — | $14K | 11.96% |
| CHAMPION BENEFITS3 | 1455 LINCOLN PARKWAY, SUITE 100 ATLANTA, GA 30346 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | 15.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $323 | $2K | 6.62% |
| BENEFIT ADVISORS NETWORK LLC3 | 6830 COCHRAN ROAD SOLON, OH 44139 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $434 | $434 | 1.56% |
| CHAMPION BENEFITS3 | 1455 LINCOLN PARKWAY, SUITE 100 ATLANTA, GA 30346 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | 15.00% |
| BENEFIT ADVISORS NETWORK LLC3 | 6830 COCHRAN ROAD SOLON, OH 44139 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $419 | $419 | 1.52% |
| CHAMPION BENEFITS3 | 1455 LINCOLN PARKWAY, SUITE 100 ATLANTA, GA 30346 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | — | $3K | 15.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $267 | $1K | 6.67% |
| BENEFIT ADVISORS NETWORK LLC3 | 6830 COCHRAN ROAD SOLON, OH 44139 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $337 | $337 | 1.58% |
| CHAMPION BENEFITS3 | 1455 LINCOLN PARKWAY, SUITE 100 ATLANTA, GA 30346 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $361 | — | $361 | 14.99% |
| BENEFIT ADVISORS NETWORK LLC3 | 6830 COCHRAN ROAD SOLON, OH 44139 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $38 | $38 | 1.58% |
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 | 138 | 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) | 138 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | 374 | $117K |
| Vision | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | 374 | $117K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 142 | $28K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 88 | $21K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 101 | $28K |
| Other(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | 374 | $120K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 374 | — |
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.