| 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. | $13K | $0 | $13K | 4.49% |
| VALENT GROUP3 Filed as: VALENT GROUP, LLC | 3500 BLUE LAKE DRIVE, SUITE 120 VESTAVIA, AL 35243 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $28K | $0 | $28K | 15.00% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $103 | $103 | 0.06% |
| VALENT GROUP3 Filed as: VALENT GROUP, LLC | 3500 BLUE LAKE DRIVE, SUITE 120 VESTAVIA, AL 35243 | VISION SERVICE PLAN | $4K | $0 | $4K | 10.52% |
| HAYES BOGEYFREE LLC3 | 2040 PARKS MILL DRIVE GREENSBORO, GA 30642 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | $0 | $2K | 5.35% |
| ALICIA B CLIFTON3 Filed as: ALICIA BEAZLEY CLIFTON | 1715 SPARTAN LANE HOSCHTON, GA 30548 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | $0 | $1K | 3.28% |
| RICHARD SCOTT HAYES3 | 2040 PARKS MILL DRIVE GREENSBORO, GA 30642 | CONTINENTAL AMERICAN INSURANCE COMPANY | $898 | $0 | $898 | 2.34% |
| WILLIAM WARDLAW JR3 Filed as: WILLIAM MERRITT WARDLAW JR. | 187 SOUTH CULVER STREET LAWRENCEVILLE, GA 30046 | CONTINENTAL AMERICAN INSURANCE COMPANY | $633 | $0 | $633 | 1.65% |
| STEVEN VORDERLANDWEHR3 Filed as: STEVEN M. VORDERLANDWHER | 2100 BULLOCK BLUFF DRIVE LOGANVILLE, GA 30052 | CONTINENTAL AMERICAN INSURANCE COMPANY | $136 | $0 | $136 | 0.35% |
| TARRAH SMITHSON3 Filed as: TARRAH SMITHSON AND VARIOUS BROKERS | 410 BAROQUE DRIVE ALPHARETTA, GA 30009 | CONTINENTAL AMERICAN INSURANCE COMPANY | $32 | $0 | $32 | 0.08% |
| CHARLES S MADISON3 Filed as: CHARLES SCOTT MADISON | 3330 COBB PARKWAY NW, SUITE 324-354 ACWORTH, GA 30101 | CONTINENTAL AMERICAN INSURANCE COMPANY | $16 | $0 | $16 | 0.04% |
| MYRA C. SCHMIDT3 | 101 CAPE CHARLES DRIVE GREENVILLE, SC 29615 | AFLAC | $842 | $0 | $842 | 7.64% |
| DANIEL FITZGERALD INC3 Filed as: DANIEL FITZGERALD INC. | 3672 BAY POINT AUGUSTA, GA 30907 | AFLAC | $228 | $0 | $228 | 2.07% |
| THOMAS ROBERT GIDDENS3 | PO BOX 2517 KENNESAW, GA 30156 | AFLAC | $81 | $0 | $81 | 0.74% |
| CINDY WILLIAMS3 Filed as: CINDY T. WILLIAMS & VARIOUS BROKERS | 5539 SOUNDSIDE DRIVE, APARTMENT C GULF BREEZE, FL 32563 | AFLAC | $78 | $0 | $78 | 0.71% |
| ALICIA B CLIFTON3 Filed as: ALICIA B. CLIFTON | 1715 SPARTAN LANE HOSCHTON, GA 30548 | AFLAC | $72 | $0 | $72 | 0.65% |
| JOHN B COLLINS3 Filed as: JOHN B. COLLINS | 159 PA JOHNS ROAD NE MILLEDGEVILLE, GA 31061 | AFLAC | $34 | $0 | $34 | 0.31% |
| ANGELA B SMITH3 Filed as: ANGELA B. SMITH | 4926 GA HIGHWAY 42 NORTH FORSYTH, GA 31029 | AFLAC | $26 | $0 | $26 | 0.24% |
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 | 612 | 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) | 612 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | 708 | $283K |
| Vision | VISION SERVICE PLAN | 326 | $39K |
| Life insurance(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 612 | $194K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 612 | $183K |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 612 | $233K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 708 | — |
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.