| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | $340K | $7K | $346K | 4.07% |
| LOCKTON COMPANIES, LLC3 | 6000 FELDWOOD ROAD COLLEGE PARK, GA 30349 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $70K | $0 | $70K | 15.00% |
| LOCKTON COMPANIES, LLC3 | 3280 PEACHTREE ROAD NE ATLANTA, GA 30305 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $0 | $5K | 6.93% |
| KLD INSURANCE BENEFITS INC3 Filed as: KLD INSURANCE BENEFITS INC. | 9085 BETHEL ROAD GAINESVILLE, GA 30506 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $1K | $4K | 4.73% |
| MJ INSURANCE3 Filed as: CHARLES A. RAY AND VARIOUS AGENTS | 12010 BROOKFIELD CLUB ROAD ROSWELL, GA 30075 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $2K | $3K | 4.01% |
| TULLY AND COMPANY INC3 Filed as: TULLY AND COMPANY INC. | 1926 STONE BRIDGE LANE MARIETTA, GA 30064 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $115 | $1K | 1.83% |
| C ADAMS VOLK3 Filed as: C. ADAMS VOLK | 2295 OLD ORCHARD DRIVE MARIETTA, GA 30068 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $871 | $192 | $1K | 1.34% |
| USI INSURANCE SERVICES LLC3 | 1 CONCOURSE PARKWAY, SUITE 700 ATLANTA, GA 30328 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $715 | $0 | $715 | 0.90% |
| CAROL PURDY FIELDS3 | 204 POTOMAC COURT WOODSTOCK, GA 30188 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $392 | $0 | $392 | 0.49% |
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 | 1,256 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 17 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 94 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,367 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | 2,952 | $8.5M |
| Dental | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | 2,952 | $8.5M |
| Vision | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | 2,952 | $8.5M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,256 | $466K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,256 | $466K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,256 | $466K |
| Prescription drug | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | 2,952 | $8.5M |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,256 | $545K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,952 | — |
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.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.