| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| S S NESBITT & CO INC3 Filed as: S.S. NESBIT AND CO., INC. | 1927 FIRST AVENUE NORTH BIRMINGHAM, AL 35203 | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | $11K | $0 | $11K | 5.90% |
| VALENT GROUP3 Filed as: VALENT GROUP, LLC | 3500 BLUE LAKE DRIVE, SUITE 120 VESTAVIA, AL 35243 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $22K | $11K | $33K | 22.40% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $175 | $175 | 0.12% |
| RICHARD S. HAYES3 | 159 COLLIS ROAD EATONTON, GA 31024 | CONTINENTAL AMERICAN INSURANCE COMPANY | $4K | $0 | $4K | 13.60% |
| ALICIA CLIFTON3 | 3915 HUNTING RIDGE DRIVE LILBURN, GA 30047 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | $0 | $1K | 4.53% |
| WILLIAM M WARDLAW JR3 Filed as: WILLIAM M. WARDLAW, JR. | 368 WEST PIKE STREET, SUITE 207 LAWRENCEVILLE, GA 30046 | CONTINENTAL AMERICAN INSURANCE COMPANY | $796 | $0 | $796 | 2.46% |
| STEVEN VORDERLANDWEHR3 | 2219 MCCAHILL COURT BUFORD, GA 30519 | CONTINENTAL AMERICAN INSURANCE COMPANY | $172 | $0 | $172 | 0.53% |
| CHARLES S MADISON3 Filed as: CHARLES S. MADISON | 3303 COBB PARKWAY NW SUITE 324-354 ACWORTH, GA 30101 | CONTINENTAL AMERICAN INSURANCE COMPANY | $21 | $0 | $21 | 0.07% |
| TARRAH SMITHSON3 | 2000 BROOKE FOREST COURT ALPHARETTA, GA 30022 | CONTINENTAL AMERICAN INSURANCE COMPANY | $21 | $0 | $21 | 0.07% |
| DUSTIN ROBERT JOHNSON3 Filed as: DUSTIN R. JOHNSON | 720 SOUTH WELLS STREET APARTMENT 1716 CHICAGO, IL 60607 | CONTINENTAL AMERICAN INSURANCE COMPANY | $21 | $0 | $21 | 0.07% |
| VALENT GROUP3 Filed as: VALENT GROUP, LLC | 3500 BLUE LAKE DRIVE, SUITE 120 VESTAVIA, AL 35243 | VISION SERVICE PLAN | $3K | $0 | $3K | 8.96% |
| MYRA C. SCHMIDT3 | 101 CAPE CHARLES DRIVE GREENVILLE, SC 29615 | AFLAC | $1K | $0 | $1K | 7.67% |
| DANIEL FITZGERALD INC3 Filed as: DANIEL FITZGERALD, INC. | 3672 BAY POINT AUGUSTA, GA 30907 | AFLAC | $258 | $0 | $258 | 1.89% |
| MJ INSURANCE3 Filed as: ANGELA B. SMITH AND VARIOUS AGENTS | 2178 SANJO DRIVE LIZELLA, GA 31052 | AFLAC | $119 | $0 | $119 | 0.87% |
| THOMAS ROBERT GIDDENS3 | PO BOX 2517 KENNESAW, GA 30156 | AFLAC | $95 | $0 | $95 | 0.69% |
| ALICIA B CLIFTON3 Filed as: ALICIA B. CLIFTON | 1715 SPARTAN LANE HOSCHTON, GA 30548 | AFLAC | $88 | $0 | $88 | 0.64% |
| CINDY WILLIAMS3 Filed as: CINDY T. WILLIAMS | 1925 CATAMARAN DRIVE NAVARRE, FL 32566 | AFLAC | $46 | $0 | $46 | 0.34% |
| JOHN B COLLINS3 Filed as: JOHN B. COLLINS | 159 PA JOHNS ROAD NE MILLEDGEVILLE, GA 31061 | AFLAC | $40 | $0 | $40 | 0.29% |
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 | 539 | 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) | 539 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | 567 | $191K |
| Vision | VISION SERVICE PLAN | 277 | $28K |
| Life insurance(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 539 | $159K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 539 | $146K |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 539 | $192K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 567 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.