| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VALENT GROUP3 Filed as: VALENT GROUP, LLC | 3500 BLUE LAKE DRIVE BIRMINGHAM, AL 35243 | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | $16K | $0 | $16K | 4.98% |
| VALENT GROUP3 Filed as: VALENT GROUP, LLC | 3500 BLUE LAKE DRIVE, SUITE 120 VESTAVIA, AL 35243 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $32K | $11K | $44K | 20.21% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $104 | $104 | 0.05% |
| VALENT GROUP3 Filed as: VALENT GROUP, LLC | 3500 BLUE LAKE DRIVE, SUITE 120 VESTAVIA, AL 35243 | VISION SERVICE PLAN | $4K | $0 | $4K | 9.52% |
| HAYES BOGEYFREE LLC3 Filed as: HAYES BOGEYFREE, LLC | 2040 PARKS MILL DRIVE GREENSBORO, GA 30642 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3K | $0 | $3K | 6.17% |
| ALICIA B CLIFTON3 Filed as: ALICIA BEAZLEY CLIFTON | 1715 SPARTAN LANE HOSCHTON, GA 30548 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | $0 | $1K | 3.16% |
| WILLIAM WARDLAW JR3 Filed as: WILLIAM MERRITT WARDLAW JR | 195 GARFIELD STREET SANTA ROSA BEACH, FL 32459 | CONTINENTAL AMERICAN INSURANCE COMPANY | $646 | $0 | $646 | 1.52% |
| STEVEN VORDERLANDWEHR3 Filed as: STEVEN M. VORDERLANDWEHR | 1018 HIGHGROVE DRIVE MONROE, GA 30655 | CONTINENTAL AMERICAN INSURANCE COMPANY | $125 | $0 | $125 | 0.29% |
| CHRISTINE M SINTAY3 Filed as: CHRISTINE MARIE SINTAY | 800 SCOTIA DRIVE, SUITE 205 HYPOLUXO, FL 33462 | CONTINENTAL AMERICAN INSURANCE COMPANY | $62 | $0 | $62 | 0.15% |
| CHARLES S MADISON3 Filed as: CHARLES SCOTT MADISON | 3330 COBB PARKWAY NW, SUITE 324-354 ACWORTH, GA 30101 | CONTINENTAL AMERICAN INSURANCE COMPANY | $14 | $0 | $14 | 0.03% |
| TARRAH SMITHSON3 Filed as: TARRAH SMITHSON AND OTHER AGENTS | 410 BAROQUE DRIVE ALPHARETTA, GA 30009 | CONTINENTAL AMERICAN INSURANCE COMPANY | $12 | $0 | $12 | 0.03% |
| MYRA C. SCHMIDT3 | 101 CAPE CHARLES DRIVE GREENVILLE, SC 29615 | AFLAC | $988 | $0 | $988 | 7.88% |
| DANIEL FITZGERALD INC3 Filed as: DANIEL S. FITZGERALD | 4119 SHADY OAKS DRIVE AUGUSTA, GA 30907 | AFLAC | $274 | $0 | $274 | 2.19% |
| THOMAS ROBERT GIDDENS3 | PO BOX 2517 KENNESAW, GA 30156 | AFLAC | $95 | $0 | $95 | 0.76% |
| ALICIA B CLIFTON3 Filed as: ALICIA B. CLIFTON | 1715 SPARTAN LANE HOSCHTON, GA 30548 | AFLAC | $87 | $0 | $87 | 0.69% |
| JEFFERY S TAYLOR3 Filed as: JEFFERY S. TAYLOR AND OTHER AGENTS | 820 WHITE OAK DRIVE NEWNAN, GA 30265 | AFLAC | $40 | $0 | $40 | 0.32% |
| 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 | 4541 HICKORY SHORES BOULEVARD GULF BREEZE, FL 32563 | AFLAC | $30 | $0 | $30 | 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 | 685 | 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) | 685 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | 722 | $329K |
| Vision | VISION SERVICE PLAN | 494 | $47K |
| Life insurance(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 685 | $228K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 685 | $216K |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 685 | $271K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 722 | — |
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.