| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HOLMES SHAW INC3 Filed as: HOLMES INC | 2860 JOHNSON FERRY RD, STE 200 MARIETTA, GA 30062 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $126K | — | $126K | 9.20% |
| HOLMES SHAW INC3 | 2860 JOHNSON FERRY ROAD, SUITE 200 MARIETTA, GA 30062 | GREATER GEORGIA LIFE INSURANCE COMPANY | $61K | — | $61K | 13.58% |
| HOLMES SHAW INC3 Filed as: HOLMES, INC | 2860 JOHNSON FERRY ROAD, SUITE 200 MARIETTA, GA 30062 | GREATER GEORGIA LIFE INSURANCE COMPANY | $23K | — | $23K | 5.21% |
| LAWRENCE N HILL3 | PO BOX 1869 TIFTON, GA 31793 | GREATER GEORGIA LIFE INSURANCE COMPANY | $5K | — | $5K | 1.09% |
| HOLMES SHAW INC3 Filed as: HOLMES SHAW, INC. | 2860 JOHNSON FERRY ROAD, SUITE 200 MARIETTA, GA 30062 | ZURICH AMERICAN INSURANCE COMPANY | $8K | — | $8K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS & BLUE SHIELD OF GA INC. EIN 58-0469845 SERVICE PROVIDER | Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Contract Administrator; Claims processing; Other services Service code 12 | — | $4.2M |
| PARAGON BENEFITS, INC. EIN 58-1741732 CONTRACT ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | — | $1.9M |
| HOLMES, INC. INSURANCE BROKER | Insurance agents and brokers Service code 22 | 2860 JOHNSON FERRY RD, STE 200 MARIETTA, GA 30062 | $530K |
| GEOFFREY D THOMASON EIN 58-2241094 EMPLOYEE | Employee (plan) Service code 30 | — | $275K |
| BNY MELLON WEALTH MANAGEMENT EIN 25-0659306 INVESTMENT MANAGEMENT | Investment management Service code 28 | — | $182K |
| EDITH M LINDSAY EIN 58-2241094 EMPLOYEE | Employee (plan) Service code 30 | — | $160K |
| MOORE COLSON & COMPANY PC EIN 58-1653941 ACCOUNTANT | Accounting (including auditing) Service code 10 | — | $142K |
| SUSAN T KELLEY EIN 58-2241094 EMPLOYEE | Employee (plan) Service code 30 | — | $132K |
| THE CHARLES JORDAN GROUP CONSULTANT | Consulting (general) Service code 16 | 2300 PEACHTREE RD NW, STE A-104 ATLANTA, GA 30309 | $119K |
| MCGRIFF, SEIBELS & WILLIAMS CONSULTANT | Consulting (general) Service code 16 | 5605 GLENRIDGE DR, STE 500 ATLANTA, GA 30342 | $85K |
| VIRGINIA L BELAUS EIN 58-2241094 EMPLOYEE | Employee (plan) Service code 30 | — | $78K |
| LOCKTON EIN 20-3354970 CONSULTANT | Actuarial Service code 11 | — | $63K |
| DAVIS, MATTHEWS & QUIGLEY ATTORNEY | Legal Service code 29 | 3400 PEACHTREE RD, STE 140 ATLANTA, GA 30326 | $6K |
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 | 11,021 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 395 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 11,416 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts) | GREATER GEORGIA LIFE INSURANCE COMPANY | 0 | $2.4M |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 8,963 | $1.4M |
| Stop-loss / reinsurancereinsurance | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. | 10,301 | $2.5M |
| Other | ZURICH AMERICAN INSURANCE COMPANY | 0 | $55K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 10,301 | — |
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."
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.