Form 5500 · Employee benefit plan · DORAVILLE, GA
METRO CITY BANK
The filing calls this plan METRO CITY BANK WELFARE BENEFIT PLAN.
METRO CITY BANK of DORAVILLE, GA is a 240-participant finance and insurance employer whose group benefits are disclosed in its annual Form 5500 filing. Its broker of record is POINTENORTH INSURANCE GROUP LLC. Coverage is written through BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. and 1 other carrier. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 76-0819027 · plan 501 · plan year 2025, filed Jul 6, 2026
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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.
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 4 insured contracts covering health, dental, vision, life and disability; the largest, with BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC., covers 1,364 people.
Reported premium across the insured contracts is $3,985,507, with $203,441 in disclosed broker commissions — about 5.1% 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.
POINTENORTH INSURANCE GROUP LLC is the broker of record on 2 of the 4 contracts; the rest name a different broker or none.
Two carriers split the book: BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. and GREATER GEORGIA LIFE INSURANCE COMPANY.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | Health, Dental, Vision | 1,364 | Jan 1, 2026 | $3,732,535 | $162,670 |
| GREATER GEORGIA LIFE INSURANCE COMPANY | Disability | 232 | Jan 1, 2026 | $97,230 | $15,673 |
| GREATER GEORGIA LIFE INSURANCE COMPANY | Life | 233 | Jan 1, 2026 | $89,305 | $14,391 |
| GREATER GEORGIA LIFE INSURANCE COMPANY | Disability | 232 | Jan 1, 2026 | $66,437 | $10,707 |
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. We publish company names only.
Other plans filed by this employer
How this plan compares
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