| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: NORTHWESTERN BENEFIT CORP OF GA | 3438 PEACHTREE RD PHIPPS TOWER, SUITE 1100 ATLANTA, GA 30326 | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | $2K | $0 | $2K | 0.10% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: NORTHWESTERN BENEFIT CORP OF GA | 3438 PEACHTREE RD PHIPPS TOWER, SUITE 1100 ATLANTA, GA 30326 | SUN LIFE ASSURANCE COMPANY OF CANADA | $25K | $0 | $25K | 7.84% |
| MEDICL GROUP INSURANCE SERVICES5 | 1849 WEST NORTH TEMPLE SALT LAKE CITY, UT 84116 | SUN LIFE ASSURANCE COMPANY OF CANADA | $0 | $60 | $60 | 0.02% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: NORTHWESTERN BENEFIT CORP OF GA | 3438 PEACHTREE RD NE ATLANTA, GA 30326 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $17K | $3K | $21K | 30.38% |
| KLD INSURANCE BENEFITS INC3 Filed as: KLD INSURANCE BENEFITS, INC. | 8045 ROYAL SAINT GEORGES LANE DULUTH, GA 30097 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $6K | $8K | $14K | 20.72% |
| CAROL PURDY FIELDS3 | 204 POTOMAC COURT WOODSTOCK, GA 30188 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $591 | $5K | 7.26% |
| NORMAC SOLUTIONS INC3 Filed as: NORMAC SOLUTIONS, INC. | 3730 EVEREST DRIVE MONTGOMERY, AL 36106 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $1K | $4K | 6.62% |
| MJ INSURANCE3 Filed as: JENNIFER SMITH AND VARIOUS AGENTS | 4920 WEST SAN RAFAEL STREET TAMPA, FL 33629 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $667 | $3K | 5.14% |
| MITCHELL HECTOR MORALES3 | PO BOX 2532 NORCROSS, GA 30091 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $547 | $3K | 4.25% |
| THOMAS WAYNE FIELDS3 | 204 POTOMAC COURT WOODSTOCK, GA 30188 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | 1.82% |
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 | 368 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 369 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | 281 | $2.2M |
| Dental | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | 281 | $2.2M |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 368 | $325K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 104 | $68K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 368 | $325K |
| Prescription drug | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | 281 | $2.2M |
| Other(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 368 | $392K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 368 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.