| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RESOURCE SEVEN3 Filed as: RESOURCE SEVEN INC | 500 LANIER AVE WEST #203 FAYETTEVILLE, GA 30214 | RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 1.74% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: NORTHWESTERN BENEFIT CORP OF GA | PHIPPS TOWER SUITE 1100 3438 PEACHTREE ROAD ATLANTA, GA 30326 | SECURITY MUTUAL LIFE INSURANCE COMPANY OF NEW YORK | $2K | $0 | $2K | 6.74% |
| RESOURCE SEVEN3 | 500 W LANIER AVE FAYETTEVILLE, GA 30214 | SECURITY MUTUAL LIFE INSURANCE COMPANY OF NEW YORK | $2K | $0 | $2K | 6.01% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: NORTHWESTERN BENEFIT CORP OF GEORGI | PHIPPS TOWER SUITE 1100 3438 PEACHTREE ROAD ATLANTA, GA 30326 | EYEMED VISION CARE D/B/A FIDELITY SECURITY LIFE INSURANCE COMPANY | $1K | $0 | $1K | 9.91% |
| RESOURCE SEVEN3 Filed as: RESOURCE SEVEN, INC. | 500 LANIER AVE WEST FAYETTEVILLE, GA 30214 | EYEMED VISION CARE D/B/A FIDELITY SECURITY LIFE INSURANCE COMPANY | $572 | $0 | $572 | 5.05% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CREATIVE RISK EIN 47-4671512 STOP LOSS | Contract Administrator; Claims processing Service code 12 | — | $222K |
| HEALTHSCOPE EIN 71-0847266 STOP LOSS CARRIER | Contract Administrator; Claims processing Service code 12 | — | $71K |
| NORTHWESTERN BENEFIT CORP OF GA EIN 20-3887041 BROKER | Insurance agents and brokers Service code 22 | — | $25K |
| RESOURCE SEVEN BROKER | Insurance agents and brokers Service code 22 | 500 LANIER AVE WEST #203 FAYETTEVILLE, GA 30214 | $20K |
| TIMBERRIDGE CONSULTANTS VENDOR | Claims processing Service code 12 | 4920 ATLANTA HWY SUITE 401 ALPHARETTA, GA 30004 | $5K |
| AHH VENDOR | Claims processing Service code 12 | 7400 W. CAMPUS RD F-510 NEW ALBANY, OH 43054 | $5K |
| CLARITY BENEFIT SOLUTIONS FSA ADMIN | Claims processing Service code 12 | 77 BRANT AVENUE CLARK, NJ 07066 | $4K |
| NE GEORGIA HEALTH PARTNERS VENDOR | Claims processing Service code 12 | 743 SPRING STREET NE GAINESVILLE, GA 30501 | $3K |
| MYIDEALDOCTOR EIN 38-3884925 TELEMEDICINE | Claims processing; Contract Administrator Service code 12 | — | $3K |
| MYCATALYST EIN 26-0337749 CLAIMS | Claims processing; Contract Administrator Service code 12 | — | $2K |
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 | 110 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 110 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | RENAISSANCE LIFE & HEALTH INSURANCE COMPANY OF AMERICA | 233 | $65K |
| Vision | EYEMED VISION CARE D/B/A FIDELITY SECURITY LIFE INSURANCE COMPANY | 195 | $11K |
| Life insurance | SECURITY MUTUAL LIFE INSURANCE COMPANY OF NEW YORK | 126 | $36K |
| Long-term disability | SECURITY MUTUAL LIFE INSURANCE COMPANY OF NEW YORK | 126 | $36K |
| Other | SECURITY MUTUAL LIFE INSURANCE COMPANY OF NEW YORK | 126 | $36K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 233 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.