| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 717 NORTH HARDWOOD, SUITE 2500 DALLAS, TX 75201 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $20K | $20K | 1.50% |
| LOCKTON COMPANIES, LLC3 | 3280 PEACHTREE ROAD NE., SUITE 250 ATLANTA, GA 30305 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $16K | — | $16K | 7.71% |
| CUSTOM BENEFITS PROGRAMS3 Filed as: CUSTOM BENEFITS PROGRAMS, INC. | 897 12TH STREET HAMMONTON, NJ 08037 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $12K | — | $12K | 5.89% |
| DANIEL COBB3 | 2238 TAYSIDE XING NORTHWEST KENNESAW, GA 30152 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $188 | — | $188 | 0.09% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $71 | — | $71 | 0.03% |
| EIDSON, DARELL, LAWAYNE3 | 246 INVERNESS CENTER DRIVE BIRMINGHAM, AL 35242 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $352 | — | $352 | 1.87% |
| HERRING, RICHARD, FULLER3 | 246 INVERNESS CENTER DRIVE BIRMINGHAM, AL 35242 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $275 | — | $275 | 1.46% |
| VERITAS CONSULTING GROUP LLC3 Filed as: VERITAS CONSULTING GROUP, LLC | 999 PEACHTREE STREET NE, SUITE 1500 ATLANTA, GA 30309 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $143 | — | $143 | 0.76% |
| WORKSITE BENEFITS GROUP INC3 Filed as: WORKSITE BENEFITS SERVICES, INC. | 246 INVERNESS CENTER DRIVE BIRMINGHAM, AL 35242 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $130 | — | $130 | 0.69% |
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 | 1,932 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 16 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,948 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL INSURANCE COMPANY | 4,037 | $1.1M |
| Vision | BLUE CROSS BLUE SHIELD OF GEORGIA, INC. | 3,370 | $144K |
| Life insurance | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 2,086 | $1.4M |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 2,086 | $1.4M |
| Other(3 contracts, 3 carriers) | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 2,086 | $1.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,037 | — |
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."
No prospect flags tripped on this filing.