| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RUTHERFORD FINANCIAL SERVICES INC.3 Filed as: MCFRIFF, SEIBELS & WILLIAMS | 5605 GLENRIDGE DRIVE SUITE 300 ONE PREMIER PLAZA ATLANTA, GA 30342 | DELTA DENTAL INSURANCE COMPANY | $243K | — | $243K | 9.60% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS & WILLIAMS OF GA | 5605 GLENRIDGE DR NE SUITE 300 ATLANTA, GA 303421374 | AMERITAS LIFE INS CORP | — | $10K | $10K | 2.04% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF, SEIBELS & WILLIAMS, INC | 5605 GLENRIDGE DR SUITE 300 ONE PREMIER PLAZA ATLANTA, GA 30342 | SUN LIFE ASSURANCE COMPANY OF CANADA - STOP LOSS | — | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BCBS OF GA, INC EIN 58-0469845 NONE | Other services; Other fees; Contract Administrator; Claims processing; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | 3350 PEACHTREE ROAD NE ATLANTA, GA 30326 | $2.7M |
| BCBS/CONEXIS NONE | Claims processing Service code 12 | 1100 PARK PLACE 4TH FLOOR SAN MATEO, CA 94403 | $65K |
| DISCOVERY BENEFITS EIN 90-0058554 NONE | Other services Service code 49 | 4321 20TH AVENUE S FARGO, ND 58103 | $34K |
| HARBOR FINANCIAL GROUP, LLC NONE | Investment advisory (plan) Service code 27 | 51 STATE STREET CHARLESTON, SC 29401 | $29K |
| JOHNSON & FIELDS, LLC EIN 45-2260375 NONE | Accounting (including auditing) Service code 10 | 161 EAST DOYLE STREET TOCCOA, GA 30577 | $23K |
| OLIVER WYMAN NONE | Actuarial Service code 11 | 411 EAST WISCONSIN AVENUE SUITE 1300 MILWAUKEE, WI 532024412 | $14K |
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 | 7,215 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL INSURANCE COMPANY | 10,762 | $2.5M |
| Vision | AMERITAS LIFE INS CORP | 13,173 | $486K |
| Life insurance | SUN LIFE ASSURANCE CO OF CANADA -LIFE | 4,323 | $605K |
| Short-term disability | SUN LIFE ASSURANCE CO OF CANADA -LIFE | 4,323 | $605K |
| Long-term disability | SUN LIFE ASSURANCE CO OF CANADA -LIFE | 4,323 | $605K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA - STOP LOSS | 6,314 | $179K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 13,173 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.