| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SOUTHERN PROTECTIVE GROUP LLC3 | 4595 TOWN LAKE PARKWAY BUILDING 300 SUITE 210 WOODSTOCK, GA 30189 | HARTFORD LIFE AND ACCIDENT | $29K | — | $29K | 3.39% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY LLC | 100 FRONT STREET SUITE 800 WORCESTER, MA 01608 | HARTFORD LIFE AND ACCIDENT | — | $5K | $5K | 0.62% |
| WEBTPA EMPLOYER SERVICES LLC3 | 8500 FREEPORT PARKWAY SOUTH IRVING, TX 75063 | HARTFORD LIFE AND ACCIDENT | — | $563 | $563 | 0.07% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY LLC | 5555 GLENRIDGE CONNECTOR SUITE 600 ATLANTA, GA 30115 | HARTFORD LIFE AND ACCIDENT | -$1 | — | -$1 | -0.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | P O BOX 201503 DALLAS, TX 75320 | HARTFORD LIFE AND ACCIDENT | -$1 | — | -$1 | -0.00% |
| BENEFITS ADVISORY GROUP3 | 5555 GLENRIDGE CONNECTOR NE SUITE 600 ATLANTA, GA 30342 | METROPOLITAN LIFE INSURANCE COMPANY | $28K | $74 | $28K | 7.35% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN | 250 PEHLE AVENUESUITE 400 PARK 80 PLAZA 2 SADDLE BROOK, NJ 07663 | METROPOLITAN LIFE INSURANCE COMPANY | — | $11K | $11K | 2.75% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY LLC | 300 WEST 10TH STREET WEST POINT, GA 31833 | BLUE CROSS AND BLUE SHIELD OF GEORGIA INC | $3K | — | $3K | 5.90% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY LLC | 2300 RENAISSANCE BOULEVARD KING OF PRUSSIA, PA 19406 | BLUE CROSS AND BLUE SHIELD OF GEORGIA INC | $2K | $280 | $2K | 4.54% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COVENANT ADMINISTRATORS CLAIMS ADMIN | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Plan Administrator; Claims processing Service code 12 | 2810 PREMIERE PARKWAY SUITE 400 DULUTH, GA 30097 | $363K |
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 | 382 | 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) | 382 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BERKLEY LIFE AND HEALTH INSURANCE CO | 557 | $562K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 1,328 | $386K |
| Vision | BLUE CROSS AND BLUE SHIELD OF GEORGIA INC | 726 | $54K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 693 | $863K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 693 | $863K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 693 | $863K |
| Stop-loss / reinsurancereinsurance | BERKLEY LIFE AND HEALTH INSURANCE CO | 557 | $562K |
| Other | HARTFORD LIFE AND ACCIDENT | 693 | $863K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,328 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.