| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BUCK CONSULTANTS LLC3 Filed as: BUCK CONSULTANTS, LLC | P.O. BOX 202617 DALLAS, TX 753202617 | CONTINENTAL AMERICAN INSURANCE COMPANY | $25K | — | $25K | 42.32% |
| SCOTT A SMITH3 Filed as: SCOTT A. SMITH | 5300 OAKBROOK PARKWAY SUITE 350 NORCROSS, GA 30093 | CONTINENTAL AMERICAN INSURANCE COMPANY | $471 | — | $471 | 0.79% |
| HYLANT GROUP INC3 Filed as: HYLANT GROUP, INC. | 2401 WEST BIG BEAVER ROAD SUITE 400 TROY, MI 48084 | CONTINENTAL AMERICAN INSURANCE COMPANY | $429 | — | $429 | 0.72% |
| WILLIAM M WARDLAW JR3 | 368 WEST PIKE STREET SUITE 207 LAWRENCEVILLE, GA 30046 | CONTINENTAL AMERICAN INSURANCE COMPANY | $271 | — | $271 | 0.46% |
| STEVEN VORDERLANDWEHR3 | 2219 MCCAHILL COURT BUFORD, GA 30519 | CONTINENTAL AMERICAN INSURANCE COMPANY | $127 | — | $127 | 0.21% |
| DUSTIN ROBERT JOHNSON3 Filed as: DUSTIN R JOHNSON | 5300 OAKBROOK PARKWAY SUITE 350 NORCROSS, GA 30093 | CONTINENTAL AMERICAN INSURANCE COMPANY | $63 | — | $63 | 0.11% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC. | 200 LIBERTY STREET FLOOR 6 NEW YORK, NY 10281 | ZURICH AMERICAN INSURANCE COMPANY | $325 | — | $325 | 22.52% |
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 | 1,480 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,485 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS SERVICE | 116 | $557K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 128 | $35K |
| Vision(2 contracts) | FIDELITY SECURITY LIFE INSURANCE COMPANY | 2,290 | $129K |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 1,480 | $743K |
| Long-term disability | RELIASTAR LIFE INSURANCE COMPANY | 1,480 | $743K |
| Prescription drug | CALIFORNIA PHYSICIANS SERVICE | 116 | $557K |
| Other(5 contracts, 5 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 1,480 | $848K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,290 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.