| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE, SUITE 500 SAN DIEGO, CA 92122 | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | $38K | — | $38K | 3.55% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE, SUITE 500 SAN DIEGO, CA 92122 | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. | $3K | — | $3K | 3.55% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTER DRIVE, SUITE 500 SAN DIEGO, CA 92122 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $1K | $1K | 2.47% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTER DRIVE, SUITE 500 SAN DIEGO, CA 92122 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $108 | $2K | 4.73% |
| IMPACT BENEFIT MANAGEMENT SERVICES3 Filed as: IMPACT BENEFIT MANAGEMENT | 3650 MANSELL RD., SUITE 100 ALPHARETTA, GA 30022 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $293 | — | $293 | 0.81% |
| CROOM, ROBERT, FRINK3 | 155 BRICKLEBERRY DR. ROSWELL, GA 30075 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $106 | — | $106 | 0.29% |
| GNW-EVERGREEN INSURANCE SERVICES3 Filed as: GNW - EVERGREEN INSURANCE SERVICES | 16030 VENTURA BLVD. ENCINO, CA 91436 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $45 | — | $45 | 0.12% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTER DRIVE, SUITE 500 SAN DIEGO, CA 92122 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $517 | $517 | 2.48% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTRE DRIVE, SUITE 500 SAN DIEGO, CA 92122 | EYEMED VISION CARE | $959 | — | $959 | 9.16% |
| MARSH & MCLENNAN AGENCY LLC3 | 9171 TOWNE CENTER DRIVE, SUITE 500 SAN DIEGO, CA 92122 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $215 | $8 | $223 | 3.34% |
| CROOM, ROBERT, FRINK3 | 155 BRICKLEBERRY DR. ROSWELL, GA 30075 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $182 | — | $182 | 2.72% |
| GNW-EVERGREEN INSURANCE SERVICES3 Filed as: GNW - EVERGREEN INSURANCE SERVICES | 16030 VENTURA BLVD. ENCINO, CA 91436 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $78 | — | $78 | 1.17% |
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 | 185 | 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) | 186 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | 162 | $1.1M |
| Dental | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. | 163 | $78K |
| Vision | EYEMED VISION CARE | 178 | $10K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 122 | $78K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 114 | $36K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 67 | $21K |
| Prescription drug | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | 162 | $1.1M |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 122 | $84K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 178 | — |
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."
No prospect flags tripped on this filing.