| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 3475 PIEDMONT ROAD NORTHEAST SUITE 800 ATLANTA, GA 30305 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $17K | $0 | $17K | 14.38% |
| METTILLE, MARK S3 Filed as: METTILLE, MARK, S. | 107 CANDELIGHT LANE MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $0 | $3K | 2.55% |
| METTILLE, MARK S3 Filed as: METTILLE, MARK S. | 107 CANDELIGHT LANE MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $0 | $3K | 2.24% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, INC. | 3475 PEIDMONT ROAD NE, SUITE 800 ATLANTA, GA 30305 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $720 | $0 | $720 | 0.62% |
| MARK S METTILLE3 Filed as: MARK S. METTILLE | 107 CANDELIGHT LANE MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $240 | $0 | $240 | 0.21% |
| GIS BENEFITS INC3 Filed as: GIS | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $210 | $210 | 0.18% |
| GSI BENEFITS3 Filed as: GSI | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $9 | $9 | 0.01% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 3475 PIEDMONT ROAD NORTHEAST SUITE 800 ATLANTA, GA 30305 | AMERITAS LIFE INSURANCE CORP. | $9K | $0 | $9K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 5200 NORTH PALM AVENUE, SUITE 114 FRESNO, CA 93704 | AMERITAS LIFE INSURANCE CORP. | $0 | $2K | $2K | 1.62% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 3475 PIEDMONT ROAD SUITE 800 ATLANTA, GA 30305 | COLONIAL LIFE & ACCIDENT INSURANCE CO | $4K | $0 | $4K | 10.19% |
| KLD INSURANCE BENEFITS INC3 | 9085 BETHEL ROAD GAINESVILLE, GA 30506 | COLONIAL LIFE & ACCIDENT INSURANCE CO | $1K | $820 | $2K | 4.82% |
| MJ INSURANCE3 Filed as: B V STONE INC AND VARIOUS AGENTS | 1800 SUNSET HARBOUR POINTE LAWRENCEVILLE, GA 30043 | COLONIAL LIFE & ACCIDENT INSURANCE CO | $1K | $414 | $2K | 3.92% |
| NORMAC SOLUTIONS INC3 | 3730 EVEREST DRIVE MONTGOMERY, AL 36106 | COLONIAL LIFE & ACCIDENT INSURANCE CO | $856 | $388 | $1K | 2.93% |
| CAROLE H WARREN3 | 1300 27TH PLACE SOUTH BIRMINGHAM, AL 35205 | COLONIAL LIFE & ACCIDENT INSURANCE CO | $892 | $288 | $1K | 2.78% |
| TULLY AND COMPANY INC3 | 1926 STONE BRIDGE LANE MARIETTA, GA 30064 | COLONIAL LIFE & ACCIDENT INSURANCE CO | $718 | $142 | $860 | 2.03% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | COLONIAL LIFE & ACCIDENT INSURANCE CO | $740 | $0 | $740 | 1.74% |
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 | 263 | 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) | 263 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AMERITAS LIFE INSURANCE CORP. | 268 | $94K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 268 | $94K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 263 | $116K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 263 | $116K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 263 | $116K |
| Other(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 263 | $159K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 268 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.