| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MOULTON AND HARDIN, INC.3 Filed as: MOULTON AND HARDIN INC | 1408 W 3RD AVE ALBANY, GA 31707 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $20K | $0 | $20K | 15.00% |
| JOHN WILSON3 | 721 EMERSON, SUITE 500 SAINT LOUIS, MO 63141 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | $0 | $1K | 2.00% |
| MOULTON AND HARDIN, INC.3 Filed as: MOULTON & HARDIN INC | 1408 W THIRD AVE ALBANY, GA 31702 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | $0 | $1K | 1.86% |
| ANGELA HUGHES3 | 721 EMERSON, SUITE 500 SAINT LOUIS, MO 63141 | CONTINENTAL AMERICAN INSURANCE COMPANY | $419 | $0 | $419 | 0.72% |
| JEREMY GEISLER INC3 Filed as: JEREMY GEISLER | 1795 CLARKSON ROAD SUITE 301 CHESTERFIELD, MO 63017 | CONTINENTAL AMERICAN INSURANCE COMPANY | $396 | $0 | $396 | 0.68% |
| JACQUELINE G KINDERMAN3 Filed as: JACQUELINE KINDERMAN | 425 MAIN STREET BROOKVILLE, PA 15825 | CONTINENTAL AMERICAN INSURANCE COMPANY | $317 | $0 | $317 | 0.54% |
| BRADLEY K HARRISON3 | 210 PRODO DRIVE JEFFERSON CITY, MO 65109 | CONTINENTAL AMERICAN INSURANCE COMPANY | $234 | $0 | $234 | 0.40% |
| LYNN WARDLAW3 | 187 SOUTH CULVER STREET LAWRENCEVILLE, GA 30046 | CONTINENTAL AMERICAN INSURANCE COMPANY | $221 | $0 | $221 | 0.38% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES | 3280 PEACHTREE ROAD NE SUITE 800 ATLANTA, GA 30305 | CONTINENTAL AMERICAN INSURANCE COMPANY | $198 | $0 | $198 | 0.34% |
| TYSON C FUNK3 | 917 CROWN POINT TERRACE CT WILDWOOD, MO 63021 | CONTINENTAL AMERICAN INSURANCE COMPANY | $76 | $0 | $76 | 0.13% |
| MICHAEL B PETERS3 | 3385 SHOAL CREEK ROAD MONROE, GA 30656 | CONTINENTAL AMERICAN INSURANCE COMPANY | $52 | $0 | $52 | 0.09% |
| SANDRA L SIEBERT3 | 6070 TANGLETREE DRIVE ROSWELL, GA 30075 | CONTINENTAL AMERICAN INSURANCE COMPANY | $52 | $0 | $52 | 0.09% |
| MELISSA JONES AND ASSOCIATES LLC3 Filed as: MELISSA JONES AND ASSOCIATES | 103 PENNANT DRIVE WASHINGTON, MO 63090 | CONTINENTAL AMERICAN INSURANCE COMPANY | $50 | $0 | $50 | 0.09% |
| AUSTIN J PETERSON3 | 11116 AURORA AVE URBANDALE, IA 50322 | CONTINENTAL AMERICAN INSURANCE COMPANY | $46 | $0 | $46 | 0.08% |
| FLJ INC3 | 1600 HERITAGE LANDING STE 115 ST CHARLES, MO 63303 | CONTINENTAL AMERICAN INSURANCE COMPANY | $46 | $0 | $46 | 0.08% |
| LAURIE S WEBER3 | 2200 ANNISTON DRIVE WASHINGTON, MA 63090 | CONTINENTAL AMERICAN INSURANCE COMPANY | $38 | $0 | $38 | 0.06% |
| JEFFREY M SATTERLEE3 | 6565 AMERICAS PKWY SUITE 115 ALBUQUERQUE, NC 87110 | CONTINENTAL AMERICAN INSURANCE COMPANY | $30 | $0 | $30 | 0.05% |
| WILLIAM WARDLAW JR3 Filed as: WILLIAM WARDLAW | 187 CULVER STREET LAWRENCEVILLE, GA 30046 | CONTINENTAL AMERICAN INSURANCE COMPANY | $29 | $0 | $29 | 0.05% |
| BRENDAN N DUSHA3 | 4155 SHENANDOAH AVE SAINT LOUIS, MO 63110 | CONTINENTAL AMERICAN INSURANCE COMPANY | $14 | $0 | $14 | 0.02% |
| JOHN P KOWN II3 | 1275 SHILOH ROAD SUITE 2260 KENNESAW, GA 30144 | CONTINENTAL AMERICAN INSURANCE COMPANY | $14 | $0 | $14 | 0.02% |
| BRENDA DUSHA3 | 4155 SHENANDOAH AVE SAINT LOUIS, MO 63110 | CONTINENTAL AMERICAN INSURANCE COMPANY | $14 | $0 | $14 | 0.02% |
| VANDEEGRIFF INC3 | 1600 HERITAGE LANDING SUTIE 115 SAINT CHARLES, MO 63303 | CONTINENTAL AMERICAN INSURANCE COMPANY | $5 | $0 | $5 | 0.01% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS CORNERSTONE LLC | 721 EMERSON, SUITE 500 SAINT LOUIS, MO 63141 | CONTINENTAL AMERICAN INSURANCE COMPANY | $4 | $0 | $4 | 0.01% |
| NATHAN L HARRISON3 | 16024 MANCHESTER ROAD ELLISVILLE, MO 63011 | CONTINENTAL AMERICAN INSURANCE COMPANY | $4 | $0 | $4 | 0.01% |
| ALEXANDER I MIRO3 Filed as: ALEXANDER MIRO | 3406 KEENES EDGE COLUMBIA, MO 65201 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2 | $0 | $2 | 0.00% |
| JOANNA D VIDAKIS3 | 9032 WHITEHAVEN DRIVE ST LOUIS, MO 63123 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2 | $0 | $2 | 0.00% |
| JOHN A BACON3 | 11630 W 158TH TERRACE OAKLAND PARK, KS 66221 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
| JOHN MYERS3 | 16024 MANCHESTER RD ELLISVILLE, MO 63011 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
| V C SMITH LLC3 | 6420 FALL BRANCH DRIVE COLUMBUS, GA 31904 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
| ANDREW D KOWN3 | 710 CREEKGARDEN COURT ATLANTA, GA 30339 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
| FRAN C HARGARTEN III3 | 1140 MOSSY ROCK ROAD NW KENNESAW, GA 30152 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
| ALICIA CLIFTON3 | 3915 HUNTING RIDGE DRIVE LILBURN, GA 30047 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
| COLLEEN M KIRKLAND3 | 11050 CRABAPPLE ROAD SUITE C107 ROSWELL, GA 30075 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
| MOULTON AND HARDIN, INC.3 Filed as: MOULTON AND HARDIN INC | 1408 W 3RD AVE ALBANY, GA 31707 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | $0 | $6K | 15.00% |
| MOULTON AND HARDIN, INC.3 Filed as: MOULTON & HARDIN INC | 1408 W 3RD AVE ALBANY, GA 31702 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | $0 | $5K | 15.00% |
| MOULTON AND HARDIN, INC.3 Filed as: MOULTON & HARDIN, INC. | 1408 W 3RD AVE ALBANY, GA 31707 | EYEMED | $2K | $0 | $2K | 10.16% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES - ATLANTA | PO BOX 741738 ATLANTA, GA 30374 | EYEMED | $2 | $0 | $2 | 0.01% |
| MOULTON AND HARDIN, INC.3 Filed as: MOULTON AND HARDIN INC | 1408 W 3RD AVE ALBANY, GA 31707 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $529 | $0 | $529 | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE EIN 59-1031071 CLAIMS RELATED SERVICES | Named fiduciary; Direct payment from the plan; Non-monetary compensation; Contract Administrator; Participant communication; Other services; Float revenue; Claims processing Service code 12 | — | $86K |
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 | 271 | 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) | 271 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 384 | $479K |
| Vision | EYEMED | 318 | $24K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $131K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $38K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $30K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 384 | $479K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 384 | $479K |
| Other(2 contracts, 2 carriers) | CONTINENTAL AMERICAN INSURANCE COMPANY | 194 | $62K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 384 | — |
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.