Form 5500 · Employee benefit plan · ATLANTA, GA
JIM ELLIS ATLANTA, INC.
The filing calls this plan JIM ELLIS ATLANTA, INC. HEALTH AND WELFARE PLAN.
JIM ELLIS ATLANTA, INC. of ATLANTA, GA spreads its employee benefits across 3 insurance carriers, according to its Form 5500 Schedule A. Its broker of record is TOTEM OUTSOURCING LLC. Coverage is written through BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. and 2 other carriers. The plan's most recent policy period ended in March.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 58-1500444 · plan 501 · plan year 2025, filed Jun 18, 2026
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101 other employer plans in Georgia have policy years ending in March. See the full list on the renewal calendar, or ask for it in Claude or ChatGPT.
How this plan is funded
Funding not settled by the filing
The filing does not report enough to settle how this plan pays for benefits.
Benefits declared on this filing
One contract on this filing does not say which benefits it covers, so a line above may be insured by it.
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.
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 3 insured contracts covering dental, vision, life and disability; the largest, with BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC., covers 1,573 people.
The filing declares dental, vision, life, disability and health. Health appears with no insured contract on Schedule A. That coverage may be self-funded, placed with a carrier that is not on this filing, or written on the contract here that does not say what it covers.
Reported premium across the insured contracts is $1,554,639, with $236,274 in disclosed broker commissions — about 15% of premium.
The most recent policy period ended in March, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
TOTEM OUTSOURCING LLC is the broker of record on 2 of the 3 contracts; the rest name a different broker or none.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| GREATER GEORGIA LIFE INSURANCE COMPANY | Life, Disability | 1,531 | Apr 1, 2025 | $498,422 | $111,740 |
| BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | Dental, Vision | 1,573 | Jan 1, 2026 | $867,085 | $86,708 |
| RELIASTAR LIFE INSURANCE COMPANY | — | 920 | Jan 1, 2026 | $189,132 | $37,826 |
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.
Other plans filed by this employer
How this plan compares
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Renewal calendar
101 other employer plans in Georgia are April 1 renewals (policy year ends March).
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