| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SCHOTT, CHRISTOPHER D3 Filed as: SCHOTT,CHRISTOPHER D | 725 COGDELL RDG MILTON, GA 30004 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $51K | $20K | $71K | 6.76% |
| WISTED, DANIEL, J3 Filed as: WISTED, DANIEL, J STE 325 | 3440 PRESTON RIDGE RD ALPHARETTA, GA 30005 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $23K | $11K | $34K | 8.27% |
| WISTED, DANIEL, J3 | PRESTON RDG IV STE 325 3440 PRESTON RIDGE RD ALPHARETTA, GA 30005 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $16K | $12K | $28K | 6.86% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES STE 300 | 1120 SANCTUARY PKWY ALPHARETTA, GA 30009 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $24K | — | $24K | 5.89% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC. -HQ | ATTN ERICA MENDEZ 1301 DOVE ST STE 200 NEWPORT BEACH, CA 92660 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $14K | $14K | 3.46% |
| WISTED, DANIEL, J3 | PRESTON RDG IV STE 325 3440 PRESTON RIDGE RD ALPHARETTA, GA 30005 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $8K | $5K | $13K | 8.47% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | STE 300 1120 SANCTUARY PKWY ALPHARETTA, GA 30009 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $10K | — | $10K | 6.05% |
| WISTED, DANIEL, J3 | STE 325 3440 PRESTON RIDGE RD ALPHARETTA, GA 30005 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $4K | $4K | $8K | 4.99% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC. -HQ | ATTN ERICA MENDEZ 1301 DOVE ST STE 200 NEWPORT BEACH, CA 92660 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | — | $6K | $6K | 3.65% |
| SCHOTT, CHRISTOPHER D3 Filed as: SCHOTT,CHRISTOPHER D | 725 COGDELL RDG MILTON, GA 30004 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $2K | $8K | 6.44% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | STE 300 1120 SANCTUARY PKWY ALPHARETTA, GA 30009 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5K | — | $5K | 8.24% |
| WISTED, DANIEL, J3 | STE 325 3440 PRESTON RIDGE RD ALPHARETTA, GA 30005 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $2K | $5K | 8.15% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC. -HQ | ATTN ERICA MENDEZ 1301 DOVE ST STE 200 NEWPORT BEACH, CA 92660 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $4K | $4K | 7.21% |
| WISTED, DANIEL, J3 | PRESTON RDG IV STE 325 3440 PRESTON RIDGE RD ALPHARETTA, GA 30005 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $2K | $4K | 6.32% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES NORTHEAST,INC. | 199 WATER STREET NEW YORK, NY 10038 | FEDERAL INSURANCE COMPANY | $6K | — | $6K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES,INC EIN 41-1289245 CLAIMS PROCESSOR | Other services; Claims processing Service code 12 | — | $519K |
| CAREBRIDGE CORP EIN 23-2614764 EAP | Contract Administrator Service code 13 | — | $14K |
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 | 1,215 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 20 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,235 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 51 | $315K |
| Dental | AETNA LIFE INSURANCE COMPANY | 51 | $315K |
| Vision(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 776 | $429K |
| Life insurance(4 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,175 | $1.6M |
| Short-term disability(3 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 128 | $627K |
| Long-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,175 | $1.2M |
| Stop-loss / reinsurancereinsurance | UNITED HEALTHCARE INSURANCE COMPANY | 1,791 | $1.2M |
| Other(4 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,175 | $1.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,791 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.