| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PALMER AND CAY LLC | 3050 PEACHTREE ROAD NW, SUITE 475 ATLANTA, GA 30305 | HARTFORD LIFE AND ACCIDENT | $58K | $0 | $58K | 18.20% |
| R J K & ASSOCIATES INC3 Filed as: R J K AND ASSOCIATES, INC. | 777 DREWRY STREET NE ATLANTA, GA 30306 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $14K | $1K | $16K | 11.05% |
| CAROLE H WARREN3 Filed as: CAROLE H. WARREN | 2716 HANOVER CIRCLE BIRMINGHAM, AL 35205 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $2K | $7K | 4.73% |
| SANTE CONCEPTS INC3 Filed as: SANTE CONCEPTS, INC. | 94 BARTLETT WAT DALLAS, TX 30157 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $0 | $4K | 2.87% |
| DAVID TYLER BURRUS3 | 254 STRATHAVEN LANE PELHAM, AL 35124 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $622 | $2K | $2K | 1.52% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 Filed as: EDGEWOOD PARTNERS INS & OTHER AGENT | 2405 SATELLITE BOULEVARD, SUITE 200 DULUTH, GA 30096 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $80 | $2K | 1.51% |
| ASSUREDPARTNERS3 Filed as: BERTHA PATRICIA SHEPHERD | PO BOX 3216 CRESTLINE, CA 92325 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $878 | $31 | $909 | 0.64% |
| LESLIE BUSSEY3 Filed as: LESLIE W. BUSSEY | PO BOX 2787 ACWORTH, GA 30102 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $704 | $0 | $704 | 0.49% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PALMER AND CAY, LLC | 3050 PEACHTREE ROAD NW, SUITE 475 ATLANTA, GA 30305 | FSL | $3K | $0 | $3K | 5.00% |
| R J K & ASSOCIATES INC3 Filed as: R J K AND ASSOCIATES, INC. | 1800 PEACHTREE STREET NW ATLANTA, GA 30309 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $787 | $67 | $854 | 16.20% |
| ASSUREDPARTNERS3 Filed as: BERTHA PATRICIA SHEPHERD | PO BOX 3216 CRESTLINE, CA 92325 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $213 | $9 | $222 | 4.21% |
| SANTE CONCEPTS INC3 Filed as: SANTE CONCEPTS, INC. | 94 BARTLETT WAT DALLAS, GA 30157 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $153 | $0 | $153 | 2.90% |
| PATRICIA A DUNCAN3 Filed as: PATRICIA ANN WOODING | 5494 MOUNTAIN VIEW PASS STONE MOUNTAIN, GA 30087 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $130 | $0 | $130 | 2.47% |
| MJ INSURANCE3 Filed as: CAROLE WARREN AND VARIOUS AGENTS | 2716 HANOVER CIRCLE BIRMINGHAM, AL 35205 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $33 | $4 | $37 | 0.70% |
| MCCAREY INC3 Filed as: MCCAREY, INC. | 6320 GREENHAVEN DRIVE CARLSBAD, CA 92009 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $26 | $9 | $35 | 0.66% |
| LESLIE BUSSEY3 Filed as: LESLIE W. BUSSEY | PO BOX 2787 ACWORTH, GA 30102 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $27 | $0 | $27 | 0.51% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 2405 SATELLITE BOULEVARD, SUITE 200 DULUTH, GA 30096 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $76 | $0 | $76 | 3.97% |
| LAURIE J BURNS3 Filed as: LAURIE JANE BURNS | 1274 BICYCLE COURT YORK, SC 29745 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $28 | $0 | $28 | 1.46% |
| SANTE CONCEPTS INC3 Filed as: SANTE CONCEPTS, INC. | 94 BARTLETT WAT DALLAS, GA 30157 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $26 | $0 | $26 | 1.36% |
| R J K & ASSOCIATES INC3 Filed as: R J K AND ASSOCIATES, INC. | 777 DREWRY STREET NE ATLANTA, GA 30306 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $14 | $0 | $14 | 0.73% |
| LESLIE BUSSEY3 Filed as: LESLIE W. BUSSEY | PO BOX 2787 ACWORTH, GA 30102 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $12 | $0 | $12 | 0.63% |
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 | 763 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 763 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | FSL | 557 | $51K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 763 | $317K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 763 | $317K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 763 | $317K |
| Other(4 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 763 | $467K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 763 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.