| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 | 3350 RIVERWOOD PARKWAY SUITE 600 ATLANTA, GA 30339 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $12K | $104K | $116K | 5.79% |
| ACRISURE LLC3 | 3350 RIVERWOOD PARKWAY #600 ATLANTA, GA 30339 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | — | $6K | 15.00% |
| ACRISURE LLC3 | 3350 RIVERWOOD PARKWAY #600 ATLANTA, GA 30339 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | — | $5K | 15.00% |
| ACRISURE LLC3 | 3350 RIVERWOOD PARKWAY #600 ATLANTA, GA 30339 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 15.00% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA VCG CONSULTANTS | 3350 RIVERWOOD PARKWAY STE 600 ATLANTA, GA 30339 | VISION SERVICE PLAN | $993 | — | $993 | 5.89% |
| ROBERT M LYMAN3 Filed as: ROBERT M LYMAN SR | 1145 SPARKLING CRYSTAL AVE HENDERSON, NV 89015 | CONTINENTAL AMERICAN INSURANCE COMPANY | $157 | — | $157 | 2.29% |
| ACRISURE LLC3 | 999 PEACHTREE STREET NE, SUITE 1500 ATLANTA, GA 30309 | CONTINENTAL AMERICAN INSURANCE COMPANY | $134 | — | $134 | 1.96% |
| KELLEY G SANGREY3 | 609 GOLD VALLEY PASS CANTON, GA 30114 | CONTINENTAL AMERICAN INSURANCE COMPANY | $88 | — | $88 | 1.29% |
| ROBERT L GOBLE3 | 1410 4TH STREET DRIVE NW UNIT 208 HICKORY, NC 28601 | CONTINENTAL AMERICAN INSURANCE COMPANY | $85 | — | $85 | 1.24% |
| BLAKE A THOMAS JR3 | 435 CHANTAN AY PLACE JOHNS CREEK, GA 30022 | CONTINENTAL AMERICAN INSURANCE COMPANY | $85 | — | $85 | 1.24% |
| ALEXANDER BARYLAK3 | 4848 N. GOLDWATER BLVD #2069 SCOTTSDALE, AZ 85251 | CONTINENTAL AMERICAN INSURANCE COMPANY | $65 | — | $65 | 0.95% |
| AMY BARYLAK3 | 9421 SAINT ANDREWS COURT DENHAM SPRINGS, LA 70726 | CONTINENTAL AMERICAN INSURANCE COMPANY | $38 | — | $38 | 0.55% |
| KATIE DENISE ALEXANDER3 Filed as: KATIE ALEXANDER | 75 W WEDGEWOOD CIRCLE NEWNAN, GA 30263 | CONTINENTAL AMERICAN INSURANCE COMPANY | $28 | — | $28 | 0.41% |
| ROBERT M LYMAN3 Filed as: ROBERT LYMAN JR | 514 ERESMA STREET HENDERSON, NV 89015 | CONTINENTAL AMERICAN INSURANCE COMPANY | $25 | — | $25 | 0.37% |
| AUSTIN J RICE3 | 2202 TAYSIDE XING NW KENNESAW, GA 30152 | CONTINENTAL AMERICAN INSURANCE COMPANY | $18 | — | $18 | 0.26% |
| ELENI A NIKOLAS3 Filed as: ELENI A KRAUSE | 3869 WINTERGREEN CT MARIETTA, GA 30062 | CONTINENTAL AMERICAN INSURANCE COMPANY | $6 | — | $6 | 0.09% |
| AMY A O SHIELDS3 Filed as: AMY A O'SHIELDS | 5159 CALGARY DRIVE DOUGLASVILLE, GA 30135 | CONTINENTAL AMERICAN INSURANCE COMPANY | $6 | — | $6 | 0.09% |
| ALEXANDER B WARD3 | 5194 FOREST VIEW CT SE MABLETON, GA 30126 | CONTINENTAL AMERICAN INSURANCE COMPANY | $5 | — | $5 | 0.07% |
| RICHARD MICHAEL TIDWELL3 Filed as: RICHARD M TIDWELL | PO BOX 1801 CUMMING, GA 30028 | CONTINENTAL AMERICAN INSURANCE COMPANY | $0 | — | $0 | 0.00% |
| MICHAEL LEROY COY3 Filed as: MICHAEL L COY | 3571 FAR WEST BLVD AUSTIN, TX 78731 | CONTINENTAL AMERICAN INSURANCE COMPANY | $0 | — | $0 | 0.00% |
| RYAN E MCPHAIL3 Filed as: RYAN MCPHAL | 206 ARBOR CT CANTON, GA 30114 | CONTINENTAL AMERICAN INSURANCE COMPANY | $0 | — | $0 | 0.00% |
| ACRISURE LLC3 | 3350 RIVERWOOD PARKWAY #600 ATLANTA, GA 30339 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $870 | — | $870 | 14.99% |
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 | 104 | 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) | 104 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 104 | $2.0M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 104 | $2.0M |
| Vision | VISION SERVICE PLAN | 86 | $17K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 121 | $42K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 121 | $34K |
| Other(3 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 121 | $40K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 121 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.