Current Net Invoice Due
$41,202.00
Billing Cycle: November 1β30, 2026
Active Enrolled Headcount
308 Lives
Across 25 Georgia Campus Sites
Carrier Prorated Credits
-$310.00
3 Departures β’ 30-Day Policy Adjust
Chroma FICA Tax Captured
+$23,129.57
Net Benefit to Chroma: +$13,769.57/mo
STATEMENT OF ACCOUNT & INVOICE
Section 125 Administration & Carrier Premium Remittance
AUTHORIZED DRAFT
INVOICE #: INV-CHROMA-2026-11
Issue Date
November 1, 2026
Payment Due Date
November 15, 2026
Billed To Client:
Chroma Early Learning Academy LLC
Attn: Gregina Watkins (Office Manager)
2300 Parklake Dr NE, Suite 150, Atlanta, GA 30345
Managing Partner: Charan Singh ([email protected])
Plan Administrator & Broker of Record:
Shielded Horizons LLC
Director Robert Hill, Benefits Advisor
GA DOI Lic. #19559059 β’ NPN #839439
Dedicated Remittance: [email protected]
| Benefit Description & Carrier Line Item | Code | Enrolled | Rate (PEPM) | Subtotal |
|---|---|---|---|---|
| Gross Program Billing Subtotal: | $41,512.00 | |||
| Less: Carrier Mid-Month Departure Credits: | -$310.00 | |||
| TOTAL NET AMOUNT DUE: | $41,202.00 | |||
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