| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 203991 DALLAS, TX 75320 | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | $112K | — | $112K | 4.61% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 999 3RD AVENUE, SUITE 1400 SEATTLE, WA 98104 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $27 | $1K | 0.80% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 1018 WEST 9TH AVENUE KING OF PRUSSIA, PA 19406 | METROPOLITAN LIFE INSURANCE COMPANY | — | $160 | $160 | 0.09% |
| KIMBERLY D FARMER3 Filed as: KIMBERLY B. FARMER | 4931 RIVERSIDE DRIVE MACON, GA 31210 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $6K | — | $6K | 14.82% |
| PATRICIA R ARWOOD3 Filed as: PATRICIA R. ARWOOD | 851 CHRISTIAN ROAD JULIETTE, GA 31046 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $68 | — | $68 | 0.16% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 600 HIGHWAY 169 SOUTH, SUITE 1200 SAINT LOUIS, MO 55426 | EYEMED | $3K | — | $3K | 10.79% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 201629 DALLAS, TX 75320 | AETNA LIFE INSURANCE COMPANY | -$25K | — | -$25K | -220.13% |
| WILLIAM FARMER3 Filed as: WILLIAM G. FARMER | 4931 RIVERSIDE DRIVE, SUITE 100C MACON, GA 31210 | AFLAC | $296 | — | $296 | 4.65% |
| JAMES M PITZ3 Filed as: JAMES M.PITZ | 84 MINK DRIVE CATAULA, GA 31804 | AFLAC | $144 | — | $144 | 2.26% |
| JASON B WEST3 Filed as: JASON B. WEST | 6501 PEAKE ROAD, SUITE 950 MACON, GA 31210 | AFLAC | $78 | — | $78 | 1.22% |
| PATRICIA R ARWOOD3 Filed as: PATRICIA R. ARWOOD | 851 CHRISTIAN ROAD JULIETTE, GA 31046 | AFLAC | $77 | — | $77 | 1.21% |
| KIMBERLY D FARMER3 Filed as: KIMBERLY D. FARMER | 4931 RIVERSIDE DRIVE, SUITE 100C MACON, GA 31210 | AFLAC | $48 | — | $48 | 0.75% |
| WILLIAM L AMOS & CO INC3 Filed as: WILLIAM L. AMOS AND COMPANY, INC. | 6801 RIVER ROAD, SUITE 205 COLUMBUS, GA 31904 | AFLAC | $42 | — | $42 | 0.66% |
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 | 358 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 361 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | 510 | $2.5M |
| Dental | AETNA LIFE INSURANCE COMPANY | 29 | $12K |
| Vision | EYEMED | 547 | $32K |
| Life insurance(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 373 | $232K |
| Short-term disability(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 373 | $191K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 373 | $179K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | 510 | $2.4M |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 373 | $186K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 547 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.