| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: NORTHWESTERN BENEFIT | 3333 RIVERWOOD PARKWAY SUITE 400 ATLANTA, GA 30339 | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | $66K | $0 | $66K | 3.50% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: NORTHWESTERN BENEFIT | 3333 RIVERWOOD PARKWAY SUITE 400 ATLANTA, GA 30339 | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | $26K | $0 | $26K | 5.55% |
| GROUP RISK SPECIALISTS INC3 Filed as: GROUP RISK SPECIALISTS, INC | 3340 PEACHTREE ROAD NE SUITE 1525 ATLANTA, GA 30326 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $14K | $0 | $14K | 12.09% |
| NORTHWESTEN BENEFIT3 | 3333 RIVERWOOD PARKWAY SUITE 400 ATLANTA, GA 30339 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $11K | $0 | $11K | 9.71% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHAGAN AVE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $126 | $126 | 0.11% |
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 | 362 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 363 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | 365 | $2.5M |
| Dental | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | 365 | $461K |
| Vision | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | 365 | $461K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 362 | $113K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 362 | $113K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ALABAMA | 31 | $195K |
| Other(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF ALABAMA | 362 | $308K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 365 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.