| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: NORTHWESTERN BENEFIT CORP OF GA | PHIPPS TOWER SUITE 1100 3438 PEACHTREE ROAD ATLANTA, GA 30326 | BLUE CROSS BLUE SHIELD OF GEORGIA, INC. | $75K | $3K | $78K | 6.31% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: NORTHWESTERN BENEFIT CORP OF GA | PHIPPS TOWER SUITE 1100 3438 PEACHTREE ROAD NE ATLANTA, GA 303261555 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $257 | $2K | 17.01% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: NORTHWESTERN BENEFIT CORP OF GA | PHIPPS TOWER SUITE 1100 3438 PEACHTREE ROAD ATLANTA, GA 303261555 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $355 | $2K | 18.06% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: NORTHWESTERN BENEFIT CORP OF GA | PHIPPS TOWER SUITE 1100 3438 PEACHTREE ROAD ATLANTA, GA 303261555 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $212 | $1K | 17.59% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: NORTHWESTERN BENEFIT CORP OF GA | PHIPPS TOWER SUITE 1100 3438 PEACHTREE ROAD ATLANTA, GA 30326 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $315 | $49 | $364 | 9.22% |
| KLD INSURANCE BENEFITS INC3 Filed as: KLD INSURANCE BENEFITS INC. | 9085 BETHEL ROAD GAINESVILLE, GA 30506 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $121 | $64 | $185 | 4.69% |
| ASSUREDPARTNERS3 Filed as: JENNIFER ROSE SMITH | 4920 W SAN RAFAEL STREET TAMPA, FL 33629 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $64 | — | $64 | 1.62% |
| MARIA VERONICA JARQUE3 | 4085 NOBEL DRIVE #29 SAN DIEGO, CA 92122 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $44 | $7 | $51 | 1.29% |
| VINSON K ELLENBERG3 | 905 ADAIR AVENUE NE ATLANTA, GA 30306 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $38 | $2 | $40 | 1.01% |
| C MARIE ADAMS VOLK3 | 2295 OLD ORCHARD DRIVE MARIETTA, GA 30068 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $26 | $11 | $37 | 0.94% |
| TYLER HERRINGTON TORBETT3 | 3604 ROBINSON WALK DRIVE MARIETTA, GA 30068 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $16 | $14 | $30 | 0.76% |
| EMILY PORRECA3 | 146 WINDFIELDS LANE WOODSTOCK, GA 30188 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $26 | $3 | $29 | 0.73% |
| CD FRAZIER ASSOCIATES INC3 Filed as: CD FRAZIER ASSOCIATES INC. | 8631 STONEFACE ROAD CHARLOTTE, NC 28214 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $17 | $4 | $21 | 0.53% |
| NORMAC SOLUTIONS INC3 Filed as: NORMAC SOLUTIONS INC. | 3730 EVEREST DRIVE MONTGOMERY, AL 36106 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $14 | $3 | $17 | 0.43% |
| CAROL BARNES3 | 2561 FALCON RIDGE DRIVE GRAYSON, GA 30017 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $12 | $2 | $14 | 0.35% |
| EDGHILL ENTERPRISES LLC3 | 3403 E SEEBLING MILE ROAD GRAND ISLAND, NE 68801 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $10 | $1 | $11 | 0.28% |
| LAURA B WETT3 | 8194 HYDE AVENUE SOUTH COTTAGE GROVE, MN 55016 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.15% |
| NORTH FLORIDA BROKER SOLUTIONS LLC3 | 1550 HARRINGTON PARK DRIVE JACKSONVILLE, FL 32225 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3 | $3 | $6 | 0.15% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.03% |
| KEVIN MURPHY3 Filed as: KEVIN ARMSTRONG INSURANCE INC. | 4027 WEST FAIDLEY GRAND ISLAND, NE 68803 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.03% |
| JAKORP INC3 Filed as: JAKORP INC. | PO BOX 27207 SAN DIEGO, CA 92109 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.03% |
| DAVID MASON DOKELL3 | 127 GREAT POINT DRIVE MOORESVILLE, NC 28117 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.03% |
| MICHAEL C WALKER3 Filed as: MICHAEL J MINNEY | PO BOX 365 POWAY, CA 92074 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.03% |
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 | 4 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 180 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 184 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF GEORGIA, INC. | 180 | $1.2M |
| Dental | BLUE CROSS BLUE SHIELD OF GEORGIA, INC. | 180 | $1.2M |
| Vision | BLUE CROSS BLUE SHIELD OF GEORGIA, INC. | 180 | $1.2M |
| Life insurance(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF GEORGIA, INC. | 180 | $1.3M |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 28 | $8K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 24 | $13K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 42 | $16K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 180 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.