| 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 | $139K | $904 | $140K | 8.71% |
| HOLMES SHAW INC3 Filed as: HOLMES SHAW, INC. | 2860 JOHNSON FERRY RD, STE 200 MARIETTA, GA 30062 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $10K | $10K | 0.59% |
| HOLMES SHAW INC3 | 2860 JOHNSON FERRY ROAD, SUITE 200 MARIETTA, GA 30062 | GREATER GEORGIA LIFE INSURANCE COMPANY | $88K | — | $88K | 18.93% |
| 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 | $12K | — | $12K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS & BLUE SHIELD OF GA INC. EIN 58-0469845 SERVICE PROVIDER | Contract Administrator; Claims processing; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue Service code 12 | 3350 PEACHTREE RD NE ATLANTA, GA 30326 | $3.7M |
| PARAGON BENEFITS, INC. EIN 58-1741732 CONTRACT ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | 6065 BUSINESS PARK DRIVE COLUMBUS, GA 31909 | $2.0M |
| HOLMES, INC. INSURANCE BROKER | Insurance agents and brokers Service code 22 | 2860 JOHNSON FERRY RD, STE 200 MARIETTA, GA 30062 | $528K |
| GEOFFREY D THOMASON EIN 58-2241094 EMPLOYEE | Employee (plan) Service code 30 | — | $308K |
| EDITH M LINDSAY EIN 58-2241094 EMPLOYEE | Employee (plan) Service code 30 | — | $181K |
| BNY MELLON WEALTH MANAGEMENT EIN 25-0659306 INVESTMENT MANAGEMENT | Investment management Service code 28 | 3290 NORTHSIDE PKWY NW, STE 950 ATLANTA, GA 30327 | $177K |
| MOORE COLSON & COMPANY PC EIN 58-1653941 ACCOUNTANT | Accounting (including auditing) Service code 10 | 600 GALLERIA PARKWAY, SUITE 600 ATLANTA, GA 30339 | $177K |
| SUSAN T KELLEY EIN 58-2241094 EMPLOYEE | Employee (plan) Service code 30 | — | $142K |
| THE CHARLES JORDAN GROUP CONSULTANT | Consulting (general) Service code 16 | 2300 PEACHTREE RD NW, STE A-104 ATLANTA, GA 30309 | $119K |
| VIRGINIA L BELAUS EIN 58-2241094 EMPLOYEE | Employee (plan) Service code 30 | — | $86K |
| LOCKTON EIN 20-3354970 CONSULTANT | Actuarial Service code 11 | 3280 PEACHTREE RD NE, STE 250 ATLANTA, GA 30305 | $50K |
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 | 10,848 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 352 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 11,200 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts) | GREATER GEORGIA LIFE INSURANCE COMPANY | 0 | $2.6M |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 6,115 | $1.6M |
| Stop-loss / reinsurancereinsurance | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. | 10,517 | $2.9M |
| Other | ZURICH AMERICAN INSURANCE COMPANY | 0 | $78K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 10,517 | — |
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.