BenefitsLedger
Employer health plan record · Plan year 2024 · Form 5500

Carl Black Buick-Pontiac-Gmc Truck, Inc.

Retail — stores, food, auto, clothing · Kennesaw, Georgia · EIN ending 1655

Updated Filing received by DOL

Carl Black Buick-Pontiac-Gmc Truck, Inc., a retail — stores, food, auto, clothing employer in Kennesaw, Georgia, reported 249 participants in its health and welfare plan for plan year 2024. Its Form 5500 shows $813,760 in insurance premiums across 10 contracts and $207,390 in broker commissions and fees. The plan is a mix of insured and self-funded coverage. The Department of Labor received the filing on October 27, 2025, before the deadline.

Participants
249
+1.6% vs 2023
Premiums filed
$813,760
premium not reported on 1 medical contract
Broker commissions + fees
$207,390
+32.5% vs 2023
Commission rate
n/a
needs insured medical premium

Who was paid on Carl Black Buick-Pontiac-Gmc Truck, Inc.'s plan

Schedule A, Part I lists each broker or agent paid on each insurance contract and the amount. Totals below add every contract Carl Black Buick-Pontiac-Gmc Truck, Inc. filed for 2024.

Broker or agentCommissionsFeesTotalContracts
HUB International · Acworth, GA$114,338$20,935$135,27310
Fox Everett-Div of Hub Intl · Ridgeland, MS$44,385$0$44,3851
Web Benefits Design Corporation · Orlando, FL$0$27,732$27,7324

Source: DOL Form 5500 Schedule A, Part I (broker commissions and fees), plan year 2024, as published in EBSA's 2024 "Latest" dataset. Part I names whoever the carrier paid, which can be a firm or an individual agent; both are public record. Amounts exclude pay from carriers not tied to a listed contract.

Insurance contracts and carriers

Every insurance contract reported on Schedule A: carrier, what it covers, people covered at year end, earned premium, and broker compensation.

Carrier · coverageCoveredPremiumBroker payRate
Blue Cross and Blue Shield of Floridaprescription drug73$813,760$40,6885.0%
United of Omaha Life Insurance Companycoverage not coded92—$23,027—
Hcc/Tokio Marine Incstop-loss184—$44,385—
Metropolitan Life Insurance Companydental, vision476—$23,556—
United of Omaha Life Insurance Companylife457—$5,071—
United of Omaha Life Insurance Companycoverage not coded69—$3,731—
United of Omaha Life Insurance Companycoverage not coded144—$21,958—
United of Omaha Life Insurance Companycoverage not coded155—$34,215—
United of Omaha Life Insurance Companycoverage not coded96—$5,418—
Brella Services, Inc - Anselhealth47—$5,341—

Source: DOL Form 5500 Schedule A, plan year 2024. Self-funded medical coverage has no premium; amounts shown for it are stop-loss or administrative contracts.

How Carl Black Buick-Pontiac-Gmc Truck, Inc. compares

Medians across employers for plan year 2024, the most recent complete year. Commission rates use fully insured medical contracts only; dollar medians use every employer that disclosed broker pay.

Broker commissions + fees, dollars
Carl Black Buick-Pontiac-Gmc Truck, Inc.
$207,390
Commission rate, % of medical premium

Not computable: no insured medical premium on the filing.

Source: BenefitsLedger benchmarks from 58,547 employer health plans with 100 or more participants, plan year 2024. Methodology.

Year over year

$0$813,760Premiums$156,504$207,390Broker pay20232024
Carl Black Buick-Pontiac-Gmc Truck, Inc.: premiums and broker commissions + fees, 2023 vs 2024
20232024Change
Participants245249+1.6%
Premiums filed$0$813,760not comparable
Broker commissions + fees$156,504$207,390+32.5%
Commission rate———

Source: DOL Form 5500 filings for plan years 2023 and 2024.

Filings and timeliness

Plans this employer filed under its EIN with a health benefit code. Large plans are due seven months after the plan year ends, or two and a half months later with an extension; amended filings carry the amendment date, so no timing is asserted for them.

PlanPlan year endReceived by DOLTimingParticipants
Carl Black Buick-Pontiac-Gmc Truck, Inc. Health Plan#503 · insurance, general assetsApril 30, 2025October 27, 2025before deadline249

Source: DOL Form 5500 Part I and signature dates; "late" means received after the extended deadline (the 15th day of the tenth month after plan year end). What a late Form 5500 costs.

How much did Carl Black Buick-Pontiac-Gmc Truck, Inc. pay in health insurance broker commissions in 2024?

Carl Black Buick-Pontiac-Gmc Truck, Inc.'s 2024 Form 5500 reports $207,390 in broker commissions and fees across 10 insurance contracts ($158,723 in commissions, $48,667 in fees), with HUB International receiving the largest share.

Is Carl Black Buick-Pontiac-Gmc Truck, Inc.'s health plan self-funded or fully insured?

The 2024 filing indicates the plan is a mix of insured and self-funded coverage. Medical coverage is written by Brella Services, Inc - Ansel.

How does Carl Black Buick-Pontiac-Gmc Truck, Inc.'s broker compensation compare with similar employers?

A commission-to-premium ratio cannot be computed for Carl Black Buick-Pontiac-Gmc Truck, Inc. because the filing does not report medical premium on Schedule A (usual for self-funded plans). In dollars, employers with 200-499 participants that disclosed broker pay reported a median of $77,013.

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Record built October 24, 2026 from U.S. Department of Labor, EBSA Form 5500 datasets (2025, 2024, 2023 plan years, 'Latest' files). Filings can run 7 to 10 months behind the plan year; always confirm against current plan documents. BenefitsLedger is not affiliated with the U.S. Department of Labor. Open the DOL filing search.