| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FALLON BENEFITS GROUP INC.3 Filed as: FALLON BENEFITS GROUP INC | 3060 PEACHTREE ROAD NW STE 1650 ATLANTA, GA 30305 | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | $54K | — | $54K | 2.60% |
| FALLON BENEFITS GROUP INC.3 Filed as: FALLON BENEFITS GROUP INC | 3060 PEACHTREE RD NW STE 1650 ATLANTA, GA 30305 | METROPOLITAN LIFE INSURANCE COMPANY | $46K | $442 | $46K | 13.10% |
| SAMANTHA LYNN WINNINGHAM3 | 3134 HUNT ROAD ACWORTH, GA 30102 | AFLAC | $1K | $70 | $1K | 3.51% |
| MEGAN TARPEY3 | 7737 CASASIA CT ORLANDO, FL 32835 | AFLAC | $1K | — | $1K | 3.42% |
| JEFFREY WINNINGHAM3 | 3134 HUNT RD ACWORTH, GA 30102 | AFLAC | $957 | $70 | $1K | 2.49% |
| HEYWARD RICHARDSON JR3 | 140 WILDEWOOD PARK DR, STE 108 COLUMBIA, SC 29223 | AFLAC | $348 | — | $348 | 0.84% |
| CHRISTOPHER JAMES CORROW3 | 2796 ASHLEIGH LANE ALPHARETTA, GA 30004 | AFLAC | $289 | — | $289 | 0.70% |
| JUANITA A MOLTIMORE3 Filed as: JUANITA MOLTIMORE | 437 AUTUMN DRIVE RIVERDALE, GA 30274 | AFLAC | $257 | $28 | $285 | 0.69% |
| THE PERRY GROUP INC3 | 1650 SAND LAKE ROAD, STE 201D ORLANDO, FL 32809 | AFLAC | $200 | — | $200 | 0.48% |
| ANDY B GLENN II3 Filed as: ANDY GLENN II | 50 HURT PLAZA SE STE 1630 ATLANTA, GA 30303 | AFLAC | $165 | $28 | $193 | 0.47% |
| BRIDGETT DAIL3 | 8224 YAXLEY HALL DRIVE RALEIGH, NC 27616 | AFLAC | $182 | — | $182 | 0.44% |
| DAVID G COMBS3 | 1041 WINDERMERE XING CUMMING, GA 30041 | AFLAC | $145 | — | $145 | 0.35% |
| MICHAEL D AISSEN3 | 920 HOLCOMB BRIDGE RD STE 200 ROSWELL, GA 30076 | AFLAC | $131 | — | $131 | 0.32% |
| AMANDA MILLER3 | 1331 CANAL PONT ROAD LONGWOOD, FL 32750 | AFLAC | $120 | — | $120 | 0.29% |
| DAVID C BERRY3 Filed as: DAVID BERRY | 2545 HEATHWAY DR FLORENCE, SC 29501 | AFLAC | $119 | — | $119 | 0.29% |
| TEATOR'S INS PROTECTION SERVICES3 | 524 TROUTWOOD PL FUQUAY VARINA, NC 27526 | AFLAC | $97 | — | $97 | 0.24% |
| WILLIS TOWERS WATSON US LLC3 Filed as: JERRY WILLIS | 2870 PEACHTREE RD NW 898 ATLANTA, GA 30305 | AFLAC | $82 | — | $82 | 0.20% |
| RICHARD SMITHSON3 | 449 TIMBER PL MILTON, GA 30004 | AFLAC | $78 | — | $78 | 0.19% |
| ROBERT SPENCE YARBROUGH3 | 2764 N THOMPSON RD NE BROOKHAVEN, GA 30319 | AFLAC | $78 | — | $78 | 0.19% |
| ALEXANDER B WARD3 | 5194 FOREST VIEW CT SE MABLETON, GA 30126 | AFLAC | $76 | — | $76 | 0.18% |
| JACQUELINE NEAL3 | P.O. BOX 31709 MYRTLE BEACH, SC 29588 | AFLAC | $59 | — | $59 | 0.14% |
| J KENNETH SKINNER3 | P O BOX 41 NASHVILLE, GA 31639 | AFLAC | $59 | — | $59 | 0.14% |
| THOMAS ROBERT GIDDENS3 | P O BOX 2517 KENNESAW, GA 30156 | AFLAC | $54 | — | $54 | 0.13% |
| ELIZABETH SMITH3 | 727 MILWAUKEE AVE, APT 6 DUNEDIN, FL 34698 | AFLAC | $54 | — | $54 | 0.13% |
| WILLIAM L BAKER IV3 Filed as: WILLIAM BAKER IV | 1121 WEDGELAND DR RALEIGH, NC 27615 | AFLAC | $49 | — | $49 | 0.12% |
| PARTNERS BENEFIT GROUP LLC3 | 104 E 10TH ST TIFTON, GA 31794 | AFLAC | $38 | — | $38 | 0.09% |
| REGGIE C BROCK3 Filed as: REGGIE BROCK | 188 WESTBROOK DR ACWORTH, GA 30101 | AFLAC | $36 | — | $36 | 0.09% |
| JARED NICHOLS3 | 1917 CONIFER CIR CHARLOTTE, NC 28213 | AFLAC | $29 | — | $29 | 0.07% |
| THOMAS BAXTER3 | P.O. BOX 86 FAYETTEVILLE, GA 30214 | AFLAC | $26 | — | $26 | 0.06% |
| TERRANCE M LUCZAJ3 Filed as: TERRANCE LUCZAJ | 435 HARRODS LANE CHARLESTON, SC 29412 | AFLAC | $24 | — | $24 | 0.06% |
| MARGARET G THOMPSON3 Filed as: MARGARET THOMPSON | 707 KRISTINA CT PORT ORANGE, FL 32127 | AFLAC | $24 | — | $24 | 0.06% |
| SCOTT A SMITH3 Filed as: SCOTT SMITH | 5300 OAKBROOK PKWY BLDG 300 STE 350 NORCROSS, GA 30093 | AFLAC | $19 | — | $19 | 0.05% |
| KELLY LEBSACK3 | 826 NORTH ELM ST GREENSBORO, NC 27401 | AFLAC | $16 | — | $16 | 0.04% |
| DAVID C CLOUD JR3 | 12 TRENT DR SE ROME, GA 30161 | AFLAC | $15 | — | $15 | 0.04% |
| JILL DENTON3 | 3500 WESTGATE DR STE 602 DURHAM, NC 27707 | AFLAC | $15 | — | $15 | 0.04% |
| DEREK B DAVIS3 Filed as: DEREK DAVIS | 1230 SOUTHPORT SUPPLY RD SE BOLIVIA, NC 28422 | AFLAC | $14 | — | $14 | 0.03% |
| JUSTIN M GUIDI3 Filed as: JUSTIN GUIDI | 555 N PLEASANTBURG DR STE 200 GREENVILLE, SC 29607 | AFLAC | $12 | — | $12 | 0.03% |
| SHARON D ROBERTS3 Filed as: SHARON ROBERTS | PO BOX 1129 YOUNG HARRIS, GA 30582 | AFLAC | $11 | — | $11 | 0.03% |
| PAUL SHELBY AMOS II3 | 1932 WYNNTON RD 14TH FLOOR COLUMBUS, GA 31999 | AFLAC | $9 | — | $9 | 0.02% |
| STEVEN VORDERLANDWEHR3 | 1599 AMHEARST MILL DR LAWRENCEVILLE, GA 30043 | AFLAC | $8 | — | $8 | 0.02% |
| LARRY WESTON JR3 | 321 WINDSOR RD GREENVILLE, NC 27858 | AFLAC | $8 | — | $8 | 0.02% |
| DEBORAH B SMITH3 Filed as: DEBORAH SMITH | 5703 BRYNWOOD CIR NW ACWORTH, GA 30101 | AFLAC | $8 | — | $8 | 0.02% |
| JONATHAN W MCCUTCHEON3 Filed as: JONATHAN MCCUTCHEON | 1150 MALLARD LAKE DR BOGART, GA 30622 | AFLAC | $7 | — | $7 | 0.02% |
| PODNAS INC / BECK & ASSOC3 Filed as: PODNAS INC/BECK & ASSOC | 6900 HILLTOP COURT COLUMBUS, GA 31904 | AFLAC | $7 | — | $7 | 0.02% |
| DUSTIN ROBERT JOHNSON3 Filed as: DUSTIN JOHNSON | 50 HURT PLZ SE STE 995 ATLANTA, GA 30303 | AFLAC | $6 | — | $6 | 0.01% |
| JOHN PAUL THOMPSON II3 Filed as: JOHN THOMPSON II | 343 SABAL SPRINGS CT DEBARY, FL 32713 | AFLAC | $6 | — | $6 | 0.01% |
| JOHN D TYLER3 | 2131 KILEY WAY EDMOND, OK 73034 | AFLAC | $5 | — | $5 | 0.01% |
| D REGAN BRANDON3 | 214 N NEWSOM ST MINEOLA, TX 75773 | AFLAC | $5 | — | $5 | 0.01% |
| DAYTON LLC3 | 324 OLD WOOD DR COLUMBIA, SC 29212 | AFLAC | $4 | — | $4 | 0.01% |
| JAMES D DUDLEY3 Filed as: JAMES DUDLEY | 1355 LYNNFIELD RD STE 259 MEMPHIS, TN 38119 | AFLAC | $4 | — | $4 | 0.01% |
| LANCE OSBORNE3 | 21822 SEACREST LN HUNTINGTON BEACH, CA 92646 | AFLAC | $4 | — | $4 | 0.01% |
| LARRY W FLOWERS3 Filed as: LARRY FLOWERS | 2318 PROVINCIAL POINT DR GAINESVILLE, GA 30501 | AFLAC | $4 | — | $4 | 0.01% |
| RHONDA MICHELLE FREEMAN3 | 8751 PHEASANT DR CHANDLER, TX 75758 | AFLAC | $4 | — | $4 | 0.01% |
| TARRAH SMITHSON3 | 449 TIMBER PL MILTON, GA 30004 | AFLAC | $3 | — | $3 | 0.01% |
| CHRISTIE MARZARI3 | 1932 WYNNTON RD COLUMBUS, GA 31999 | AFLAC | $3 | — | $3 | 0.01% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 2502 N ROCKY POINT DR STE 400 TAMPA, FL 33607 | AFLAC | $3 | — | $3 | 0.01% |
| SCOTTI MADISON3 | 3330 COBB PARKWAY STE 324-3 ACWORTH, GA 30101 | AFLAC | $2 | — | $2 | 0.00% |
| LEE RYAN MCGRAW3 Filed as: LEE MCGRAW | 1170 MANN RD DOUGLASVILLE, GA 30134 | AFLAC | $2 | — | $2 | 0.00% |
| ALLISON FARRIS WENDELBERGER3 | 207 SANTA FE DR WALNUT CREEK, CA 94598 | AFLAC | $2 | — | $2 | 0.00% |
| LESLIE K KIMBROUGH3 Filed as: LESLIE KIMBROUGH | P.O. BOX 273488 BOCA RATON, FL 33427 | AFLAC | $1 | — | $1 | 0.00% |
| GARY W JOHNSON3 Filed as: GARY JOHNSON | 123 CENTER PARK DR STE 102 KNOXVILLE, TN 37922 | AFLAC | $1 | — | $1 | 0.00% |
| KEVIN R MCFADDEN3 Filed as: KEVIN MCFADDEN | 1820 W CANNING DR MT PLEASANT, SC 29466 | AFLAC | $1 | — | $1 | 0.00% |
| MELYNDA RAY-MCCUTCHEON3 | 1150 MALLARD LAKE DR BOGART, GA 30622 | AFLAC | $1 | — | $1 | 0.00% |
| K ABERNETHY3 | 2902 SHERYL DRIVE KINSTON, NC 28504 | AFLAC | $1 | — | $1 | 0.00% |
| DEREK DEVANE3 | 3205 JERRY SMITH RD DOVER, FL 33527 | AFLAC | $1 | — | $1 | 0.00% |
| DENA JORDAN3 | 641 HIGUERA ST, STE 300 APT 208 SAN LUIS IBISPO, CA 93401 | AFLAC | $1 | — | $1 | 0.00% |
| FALLON BENEFITS GROUP INC.3 Filed as: FALLON BENEFITS GROUP INC | 3060 PEACHTREE ST NW STE 1650 ATLANTA, GA 30305 | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC | $554 | — | $554 | 2.60% |
| JEFFREY WINNINGHAM3 | 3134 HUNT ROAD ACWORTH, GA 30102 | TRANSAMERICA LIFE INSURANCE COMPANY | $592 | — | $592 | 8.08% |
| VOLUNTARY BENEFITS AT WORK3 | 1820 THE EXCHANGE STE 750 ATLANTA, GA 30339 | TRANSAMERICA LIFE INSURANCE COMPANY | $231 | — | $231 | 3.15% |
| CHRISTOPHER JAMES CORROW3 Filed as: CHRISTOPHER J CORROW | 2796 ASHLEIGH LANE ALPHARETTA, GA 30004 | TRANSAMERICA LIFE INSURANCE COMPANY | $99 | — | $99 | 1.35% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| LIFEWORKS US INC EIN 81-1114266 NONE | Plan Administrator; Participant communication; Direct payment from the plan; Consulting (general); Other services Service code 14 | — | $7K |
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 | 220 | 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) | 220 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | 296 | $2.1M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 527 | $354K |
| Vision | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC | 281 | $21K |
| Life insurance(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 527 | $402K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 527 | $354K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 527 | $354K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 527 | $395K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 527 | — |
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.