| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 3475 PIEDMONT ROAD, SUITE 800 ATLANTA, GA 30305 | KAISER FOUNDATION HEALTH PLAN OF GEORGIA | $24K | $5K | $29K | 6.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 999 3RD AVENUE, SUITE 4100 SEATTE, WA 98104 | METROPOLITAN LIFE INSURANCE COMPANY | $11K | $27 | $11K | 12.82% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 1018 WEST 9TH AVENUE KING OF PRUSSIA, PA 19406 | METROPOLITAN LIFE INSURANCE COMPANY | — | $2K | $2K | 2.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 3475 PIEDMONT ROAD, SUITE 800 ATLANTA, GA 30305 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 25.96% |
| KLD INSURANCE BENEFITS INC3 Filed as: KLD INSURANCE BENEFITS, LTD | 9085 BETHEL ROAD GAINSVILLE, GA 30506 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $1K | $3K | 20.04% |
| CAROL PURDY FIELDS3 | 204 POTOMAC COURT WOODSTOCK, GA 30188 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $290 | $2K | 13.12% |
| DORIS REBECCA BOWDEN3 | 400 VILLAGE PARKWAY ATLANTA, GA 30306 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $336 | $945 | $1K | 9.77% |
| C MARIE ADAMS VOLK3 Filed as: C. MARIE ADAMS VOLK | 2295 OLD ORCHARD DRIVE MARIETTA, GA 30068 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $422 | $143 | $565 | 4.31% |
| THOMAS WAYNE FIELDS3 | 204 POTOMAC COURT WOODSTOCK, GA 30188 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $506 | $16 | $522 | 3.98% |
| MJ INSURANCE3 Filed as: NORMAC SOL, INC AND VARIOUS AGENTS | 3730 EVEREST DRIVE MONTGOMERY, AL 36106 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $266 | $77 | $343 | 2.62% |
No Schedule C service providers reported on this filing.
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 | 111 | 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) | 111 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF GEORGIA | 126 | $487K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 260 | $87K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 260 | $87K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 260 | $87K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 260 | $87K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 260 | $87K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN OF GEORGIA | 126 | $487K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 260 | $101K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 260 | — |
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.