| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VALENT GROUP3 Filed as: VALENT GROUP, LLC | 3500 BLUE LAKE DRIVE, SUITE 120 BIRMINGHAM, AL 35243 | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | $11K | $0 | $11K | 5.27% |
| VALENT GROUP3 Filed as: VALENT GROUP, LLC | 3500 BLUE LAKE ROAD, SUITE 120 VESTAVIA, AL 35243 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $26K | — | $26K | 16.49% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $89 | $89 | 0.06% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $16 | $16 | 0.01% |
| VALENT GROUP3 Filed as: VALENT GROUP, LLC | 3500 BLUE LAKE DRIVE, SUITE 120 VESTAVIA, AL 35243 | VISION SERVICE PLAN | $4K | $0 | $4K | 9.48% |
| RICHARD S. HAYES3 | 159 COLLIS ROAD EATONTON, GA 31024 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | $0 | $2K | 7.23% |
| ALICIA CLIFTON3 | 3915 HUNTING RIDGE DRIVE LILBURN, GA 30047 | CONTINENTAL AMERICAN INSURANCE COMPANY | $781 | $0 | $781 | 3.06% |
| WILLIAM M WARDLAW JR3 Filed as: WILLIAM M. WARDLAW JR. | UNKNOWN LAWRENCEVILLE, GA 30046 | CONTINENTAL AMERICAN INSURANCE COMPANY | $394 | $0 | $394 | 1.54% |
| STEVEN VORDERLANDWEHR3 | 2219 MCCAHILL COURT BUFORD, GA 30519 | CONTINENTAL AMERICAN INSURANCE COMPANY | $88 | $0 | $88 | 0.35% |
| DUSTIN ROBERT JOHNSON3 Filed as: DUSTIN R. JOHNSON AND OTHER AGENTS | 720 SOUTH WELLS STREET APARTMENT 1716 CHICAGO, IL 60607 | CONTINENTAL AMERICAN INSURANCE COMPANY | $16 | $0 | $16 | 0.06% |
| CHARLES S MADISON3 Filed as: CHARLES S. MADISON | 3303 COBB PARKWAY NW, SUITE 324-354 ACWORTH, GA 30101 | CONTINENTAL AMERICAN INSURANCE COMPANY | $11 | $0 | $11 | 0.04% |
| TARRAH SMITHSON3 | 2000 BROOKE FOREST COURT ALPHARETTA, GA 30022 | CONTINENTAL AMERICAN INSURANCE COMPANY | $11 | $0 | $11 | 0.04% |
| MYRA C. SCHMIDT3 | 101 CAPE CHARLES DRIVE GREENVILLE, SC 29615 | AFLAC | $981 | $0 | $981 | 7.69% |
| DANIEL FITZGERALD INC3 Filed as: DANIEL FITZGERALD, INC. | 3672 BAY POINT AUGUSTA, GA 30907 | AFLAC | $251 | $0 | $251 | 1.97% |
| ALICIA B CLIFTON3 Filed as: ALICIA B. CLIFTON | 1715 SPARTAN LANE HOSCHTON, GA 30548 | AFLAC | $98 | $0 | $98 | 0.77% |
| THOMAS ROBERT GIDDENS3 | PO BOX 2517 KENNESAW, GA 30156 | AFLAC | $91 | $0 | $91 | 0.71% |
| ANGELA B SMITH3 Filed as: ANGELA B. SMITH AND OTHER AGENTS | 2178 SANJO DRIVE LIZELLA, GA 31052 | AFLAC | $88 | $0 | $88 | 0.69% |
| JOHN B COLLINS3 Filed as: JOHN B. COLLINS | 159 PA JOHNS ROAD NE MILLEDGEVILLE, GA 31061 | AFLAC | $39 | $0 | $39 | 0.31% |
| CINDY WILLIAMS3 Filed as: CINDY T. WILLIAMS | 5539 SOUNDSIDE DRIVE, APARTMENT C GULF BREEZE, FL 32563 | AFLAC | $37 | $0 | $37 | 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 | 498 | 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) | 498 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | 600 | $205K |
| Vision | VISION SERVICE PLAN | 293 | $39K |
| Life insurance(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 498 | $169K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 498 | $156K |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 498 | $194K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 600 | — |
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.