| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS | 5605 GLENRIDGE DRIVE NE SUITE 300 ATLANTA, GA 30342 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $36K | $36K | 4.56% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: NORTHWESTERN BENEFIT CORP OF GA | 3438 PEACHTREE ROAD SUITE 1100 ATLANTA, GA 30326 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $11K | $11K | 1.44% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS OF GA | 3400 OVERTON PARK DRIVE SE SUITE 300 ATLANTA, GA 30339 | CONCORDIA INSURANCE COMPANY | $5K | $345 | $5K | 9.09% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: NORTHWESTERN BENEFITS CORP | 3438 PEACHTREE ROAD SUITE 1100 ATLANTA, GA 30326 | CONCORDIA INSURANCE COMPANY | $1K | $233 | $1K | 2.57% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | 2211 7TH AVENUE SOUTH BIRMINGHAM, AL 35233 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $3K | — | $3K | 7.69% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: NORTHWESTERN BENEFIT COMPANY | 3438 PEACHTREE ROAD NE ATLANTA, GA 30326 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $325 | $1K | $1K | 3.17% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | 2211 7TH AVENUE SOUTH BIRMINGHAM, AL 35233 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $2K | — | $2K | 7.67% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: NORTHWESTERN BENEFIT CO | 3438 PEACHTREE ROAD NE ATLANTA, GA 30326 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $165 | $516 | $681 | 3.18% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | 2211 7TH AVENUE SOUTH BIRMINGHAM, AL 35233 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $2K | — | $2K | 8.95% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: NORTHWESTERN BENEFIT CO | 3438 PEACHTREE ROAD NE ATLANTA, GA 30326 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $415 | $415 | 2.42% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | 5605 GLENRIDGE DRIVE SUITE 300 ATLANTA, GA 30342 | EYEMED VISION CARE | $528 | — | $528 | 5.92% |
| NORTHWETERN BENEFIT CORP OF GA3 | 3438 PEACHTREE ROAD SUITE 1100 ATLANTA, GA 30326 | EYEMED VISION CARE | $284 | — | $284 | 3.19% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CLAIMS ADMIN | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Plan Administrator; Claims processing Service code 12 | — | $48K |
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 | 122 | 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) | 122 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 133 | $793K |
| Dental | CONCORDIA INSURANCE COMPANY | 70 | $54K |
| Vision | EYEMED VISION CARE | 173 | $9K |
| Life insurance | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 244 | $17K |
| Short-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 243 | $43K |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 243 | $21K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 244 | — |
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.