| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TAMMY M CHAMBERS | 5500 LILBURN STONE MOUNTAIN RD, #B STONE MOUNTAIN, GA 30087 | HCC LIFE INSURANCE COMPANY | $5K | $0 | $5K | 2.00% |
| TIA GROUP, LLC Filed as: TIA GROUP LLC | 8000 IH 10 W. STE 950 SAN ANTONIO, TX 78230 | UNITED CONCORDIA INSURANCE COMPANY | $6K | $0 | $6K | 8.05% |
| TIA GROUP, LLC Filed as: TIA GROUP LLC | 8000 IH 10 W. STE 950 SAN ANTONIO, TX 78230 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 10.92% |
| TIA GROUP, LLC3 Filed as: TIA GROUP LLC | 8000 W INTERSTATE 10 STE 950 SAN ANTONIO, TX 78230 | METROPOLITAN LIFE INSURANCE COMPANY | $918 | $0 | $918 | 7.16% |
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 | 145 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 145 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HCC LIFE INSURANCE COMPANY | 145 | $240K |
| Dental | UNITED CONCORDIA INSURANCE COMPANY | 55 | $75K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 306 | $13K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 125 | $40K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 125 | $40K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 306 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.