| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| S S NESBITT & CO INC3 Filed as: S.S. NESBITT AND COMPANY | 3500 BLUE LAKE DRIVE, SUITE 120 VESTAVIA, AL 35243 | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. | $10K | — | $10K | 5.40% |
| S S NESBITT & CO INC3 Filed as: S.S. NESBIT AND COMPANY | 3500 BLUE LAKE DRIVE, SUITE 120 BIRMINGHAM, AL 35243 | HARTFORD LIFE AND ACCIDENT | $17K | $7K | $25K | 21.09% |
| RICHARD S. HAYES3 | 159 COLLIS ROAD EATONTON, GA 31024 | CONTINENTAL AMERICAN INSURANCE COMPANY | $5K | — | $5K | 15.12% |
| ALICIA CLIFTON3 | 3915 HUNTING RIDGE DRIVE LILBURN, GA 30047 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 4.66% |
| WILLIAM M WARDLAW JR3 Filed as: WILLIAM M. WARDLAW JR. | 368 WEST PIKE STREET, SUITE 207 LAWRENCEVILLE, GA 30046 | CONTINENTAL AMERICAN INSURANCE COMPANY | $831 | — | $831 | 2.59% |
| STEVEN VORDERLANDWEHR3 Filed as: STEVEN VONDERLANDWEHR | 2219 MCCAHILL COURT BUFORD, GA 30519 | CONTINENTAL AMERICAN INSURANCE COMPANY | $420 | — | $420 | 1.31% |
| CHARLES S MADISON3 Filed as: CHARLES S. MADISON | 3303 COBB PARKWAY NW SUITE 324-354 ACWORTH, GA 30101 | CONTINENTAL AMERICAN INSURANCE COMPANY | $47 | — | $47 | 0.15% |
| TARRAH SMITHSON3 | 2000 BROOKE FOREST COURT ALPHARETTA, GA 30022 | CONTINENTAL AMERICAN INSURANCE COMPANY | $47 | — | $47 | 0.15% |
| DUSTIN ROBERT JOHNSON3 Filed as: DUSTIN R. JOHNSON | 50 HURT PLAZA SE, SUITE 995 ATLANTA, GA 30306 | CONTINENTAL AMERICAN INSURANCE COMPANY | $47 | — | $47 | 0.15% |
| S S NESBITT & CO INC3 Filed as: S.S. NESBIT AND COMPANY | 3500 BLUE LAKE DRIVE, SUITE 120 VESTAVIA, AL 35243 | VISION SERVICE PLAN | $3K | — | $3K | 10.00% |
| MYRA C. SCHMIDT3 | 101 CAPE CHARLES DRIVE GREENVILLE, SC 29315 | AFLAC | $1K | — | $1K | 7.30% |
| DANIEL FITZGERALD INC3 Filed as: DANIEL FITZGERALD INC. | 3672 BAY POINT AUGUSTA, GA 30907 | AFLAC | $223 | — | $223 | 1.46% |
| ALICIA B CLIFTON3 Filed as: ALICIA B. CLIFTON | 3915 HUNTING RIDGE DRIVE SW LILBURN, GA 30047 | AFLAC | $156 | — | $156 | 1.02% |
| MJ INSURANCE3 Filed as: ANGELA B.SMITH AND VARIOUS AGENTS | 2178 SANJO DRIVE LIZELLA, GA 31052 | AFLAC | $146 | — | $146 | 0.96% |
| THOMAS ROBERT GIDDENS3 | PO BOX 2517 KENNESAW, GA 30156 | AFLAC | $96 | — | $96 | 0.63% |
| JOHN B COLLINS3 Filed as: JOHN B. COLLINS | 311 PEBBLE HOLLOW DRIVE MILLEDGEVILLE, GA 31061 | AFLAC | $49 | — | $49 | 0.32% |
| RICHARD SCOTT HAYES3 | 159 COLLIS ROAD EATONTON, GA 31024 | AFLAC | $34 | — | $34 | 0.22% |
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 | 335 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 335 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. | 514 | $190K |
| Vision | VISION SERVICE PLAN | 246 | $28K |
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 335 | $132K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 335 | $117K |
| Other(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 335 | $164K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 514 | — |
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.