| 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 PEACHTREEE ROAD ATLANTA, GA 30326 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $40K | $15K | $55K | 10.20% |
| ASHFORD ADVISORS INC3 Filed as: ASHFORD ADVISORS, INC. | SUITE 1750 ONE RAVINIA DRIVE ATLANTA, GA 30346 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $775 | — | $775 | 0.14% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: NORTHWESTERN BENEFIT CORP OF GA | PHIPPS TOWER SUITE 1100 3438 PEACHTREE ROAD ATLANTA, GA 30326 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $212 | — | $212 | 5.28% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: NORTHWESTERN BENEFIT CORP OF GA | PHIPPS TOWER SUITE 100 3438 PEACHTREE ROAD ATLANTA, GA 30326 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $154 | $3 | $157 | 3.91% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES INC. EIN 41-1289245 CLAIMS PROCESSOR | Other services; Claims processing Service code 12 | — | $329K |
| NORTHWESTERN BENEFIT CORP OF GA EIN 20-3887041 BROKER | Other commissions Service code 55 | PHIPPS TOWER SUITE 1100 3438 PEACHTREE ROAD NE ATLANTA, GA 303261172 | $0 |
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 | 337 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 341 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 669 | $627K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 337 | $543K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 337 | $543K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 337 | $543K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 337 | $543K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 337 | $543K |
| Stop-loss / reinsurancereinsurance | UNITED HEALTHCARE INSURANCE COMPANY | 669 | $627K |
| Other(3 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 337 | $551K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 669 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.