| 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 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $9K | $0 | $9K | 5.20% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: NORTHWESTERN BENEFIT CORP OF GA | 3438 PEACHTREE RD. PHIPPS TOWER, SUITE 1100 ATLANTA, GA 30326 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $1K | $1K | 1.62% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: NORTHWESTERN BENEFIT CORP OF GA | 3438 PEACHTREE RD. PHIPPS TOWER, SUITE 1100 ATLANTA, GA 30326 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $783 | $783 | 1.57% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: NORTHWESTERN BENEFIT COPR OF GA | 3438 PEACHTREE RD. PHIPPS TOWER, SUITE 1100 ATLANTA, GA 30326 | VISION SERVICE PLAN | $952 | $0 | $952 | 5.54% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF GA EIN 58-1638390 | Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Float revenue; Other fees; Claims processing Service code 12 | — | $317K |
| BLUE CROSS BLUE SHIELD EIN 58-1638390 | Claims processing; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 12 | — | $0 |
| NORTHWESTERN BENEFIT CORP OF GA | Insurance brokerage commissions and fees; Insurance agents and brokers; Other commissions Service code 22 | 3438 PEACHTREE RD PHIPPS TOWER, SUITE 1100 ATLANTA, GA 30326 | $0 |
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 | 294 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 294 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 261 | $170K |
| Vision | VISION SERVICE PLAN | 185 | $17K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 294 | $68K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 274 | $50K |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 294 | $68K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 294 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.