Form 5500 · Employee benefit plan · JEFFERSON, GA
JACKSON ELECTRIC MEMBERSHIP CORP
The filing calls this plan GROUP INSURANCE PLAN FOR EMPLOYEES OF JACKSON ELECTRIC MEMBERSHIP CORPORATION.
JACKSON ELECTRIC MEMBERSHIP CORP of JEFFERSON, GA files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is AMWINS GROUP BENEFITS, LLC. Coverage is written through CIGNA HEALTH AND LIFE INSURANCE COMPANY and 4 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 58-0301471 · plan 511 · plan year 2023, filed Jun 4, 2024
Get an email when this employer files a new Form 5500, and again about four months before its plan renews.
1,626 other employer plans in Georgia have policy years ending in December. See the full list on the renewal calendar, or ask for it in Claude or ChatGPT.
How this plan is funded
Fully insured as reported
The filing reports medical coverage through an insurance contract on Schedule A, and no money paid for benefits by the plan itself.
A stop-loss policy appears on a Form 5500 only when the plan itself is the beneficiary, or the premiums are paid from plan money. Many employers buy stop-loss and never report it here. So a plan with no stop-loss on its filing may still have it.
Benefits declared on this filing
Also declared: other welfare.
Declared benefits are the plan’s own line 8b codes on Form 5500. “Not on Schedule A” means no insured contract for that line appears on this filing. That usually means the benefit is self-funded, or it sits under a different plan number.
Where a line has more than one insured contract, the carrier and the covered figure are the largest contract's by premium. The contracts are not added up: a pharmacy carve-out and the medical carrier beside it cover the same people.
Persons covered is the count the carrier filed for that policy at the end of its policy year, and it can include dependents. Participants is the plan's own count at the start of its plan year. The two count different people, so a covered figure can be larger.
Plan brief
Schedule A lists 5 insured contracts covering health, dental, vision, life, disability and stop-loss; the largest, with CIGNA HEALTH AND LIFE INSURANCE COMPANY, covers 1,520 people.
The filing lists a stop-loss contract. On its own that does not settle whether the plan pays its own claims.
Reported premium across the insured contracts is $3,321,304, with $150,567 in disclosed broker commissions — about 4.5% of premium.
The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
AMWINS GROUP BENEFITS, LLC is the broker of record on 2 of the 5 contracts; the rest name a different broker or none.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| TRANSAMERICA INSURANCE CO. | Health | 259 | Jan 1, 2024 | $642,988 | $113,468 |
| EXPRESS SCRIPTS, INC. | Health | 259 | Jan 1, 2024 | $888,994 | $36,852 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY | Health, Stop-loss | 1,520 | Jan 1, 2024 | $1,271,012 | $247 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | Dental, Vision, Life | 675 | Jan 1, 2024 | $369,438 | $0 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | Disability | 428 | Jan 1, 2024 | $148,872 | $0 |
Covered = persons covered at policy year end, as filed on Schedule A for that policy — often certificates or one class, not the whole plan. Premium = the filing’s own premium/charges figure; “—” means not credibly reported.
Administrator and service providers
The plan administrator is from line 3a of the main form. The service providers are named on Schedule C of this filing. We publish company names only.
Reported to OSHA
Reported to OSHA for 2025: 494 employees, 10 recordable cases, 15 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
How this plan compares
Subscribers see how this compares with similar plans in Georgia. A subscription also adds this plan's filing history and the renewal calendar for its state. See plans and prices
Without an account you can open 10 employer, broker and carrier pages a day, including through an AI assistant, and 50 a day with a free account. Paid plans are what keep these records free to read.
Renewal calendar
1,626 other employer plans in Georgia are January 1 renewals (policy year ends December).
Their policy years end in December, like this plan’s, so most renew January 1. The calendar lists every insured group by renewal date and state, with broker of record, carrier and disclosed commission. You can preview the five largest in each month for free.
Claude & ChatGPT
Look up records from Claude or ChatGPT
Add Form5500Lookup to Claude or ChatGPT and ask about any employer, broker or carrier in plain English. Lookups are free. Renewal lists, full books of business and exports are included with a subscription.
Building a list or a tool from these records? Match a list you already have from $29 per 1,000 records, or license the whole dataset as a weekly file for $499 a month. See both
More employer plans in Georgia — largest plans, brokers, carriers and renewal months.