| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA HEAD CAPITAL | 2840 HILLCREEK DRIVE AUGUSTA, GA 30909 | HUMANA | $66K | $0 | $66K | 4.97% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA ACHS INSURANCE | 1201 TOWN PARK LANE EVANS, GA 30809 | HUMANA | $8K | $0 | $8K | 0.59% |
| ACRISURE LLC3 | 2840 HILLCREEK DRIVE AUGUSTA, GA 30909 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $18K | $0 | $18K | 10.01% |
| ASHFORD ADVISORS INC3 Filed as: ASHFORD ADVISORS, INC. | ONE RAVINIA DRIVE #1750 ATLANTA, GA 30346 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $363 | $0 | $363 | 0.20% |
| JEFFREY WINNINGHAM3 | 3134 HUNT ROAD ACWORTH, GA 30102 | AFLAC | $2K | $0 | $2K | 5.74% |
| SAMANTHA LYNN WINNINGHAM3 | 3134 HUNT ROAD ACWORTH, GA 30102 | AFLAC | $2K | $84 | $2K | 5.26% |
| JUANITA A MOLTIMORE3 Filed as: JUANITA MOLTIMORE | 437 AUTUMN DRIVE RIVERDALE, GA 30274 | AFLAC | $379 | $17 | $396 | 1.18% |
| ANDY B GLENN II3 | 50 HURT PLAZA SE SUITE 1630 ATLANTA, GA 30303 | AFLAC | $343 | $17 | $360 | 1.07% |
| JONATHAN W MCCUTCHEON3 Filed as: JONATHAN MCCUTCHEON | 1150 MALLARD LAKE DRIVE BOGART, GA 30622 | AFLAC | $345 | $0 | $345 | 1.03% |
| THOMAS D BAXTER3 | PO BOX 86 FAYETTEVILLE, GA 30214 | AFLAC | $246 | $0 | $246 | 0.73% |
| SABRINA M COLLINS3 Filed as: SABRINA COLLINS | 470 WOODLAWN AVE ATHENS, GA 30606 | AFLAC | $200 | $0 | $200 | 0.60% |
| CHRISTOPHER JAMES CORROW3 | 2796 ASHLEIGH LANE ALPHARETTA, GA 30004 | AFLAC | $195 | $0 | $195 | 0.58% |
| BRENDAN N DUSHA3 | 4155 SHENANDOAH AVE SAINT LOUIS, MO 63110 | AFLAC | $153 | $0 | $153 | 0.46% |
| RICHARD SMITHSON3 | 449 TIMBER PLAZA MILTON, GA 30004 | AFLAC | $153 | $0 | $153 | 0.46% |
| MICHAEL D AISSEN3 | 920 HOLCOMB BRIDGE ROAD SUITE 200 ROSWELL, GA 30076 | AFLAC | $56 | $0 | $56 | 0.17% |
| THOMAS ROBERT GIDDENS3 Filed as: THOMAS GIDDENS | PO BOX 2517 KENNESAW, GA 30156 | AFLAC | $48 | $0 | $48 | 0.14% |
| VANDEGRIFFE INC3 | 3432 W TRUMAN BLVD JEFFERSON CITY, MO 65109 | AFLAC | $36 | $0 | $36 | 0.11% |
| ANDY B GLENN II3 | 100 HARTSFIELD CENTER PKWY SUITE 500 ATLANTA, GA 30354 | AFLAC | $22 | $0 | $22 | 0.07% |
| MELYNDA RAY-MCCUTCHEON3 | 1150 MALLARD LAKE DRIVE BOGART, GA 30622 | AFLAC | $21 | $0 | $21 | 0.06% |
| WILLIAM M WARDLAW JR3 | 5300 OAKBROOK PKWY SUITE 300 NORCROSS, GA 30093 | AFLAC | $17 | $0 | $17 | 0.05% |
| NATHAN L HARRISON3 | 16024 MANCHESTER ROAD 2ND FLOOR SUITE 200 ELLISVILLE, MO 63011 | AFLAC | $15 | $0 | $15 | 0.04% |
| MRS JACKSON BOYUM3 | 2040 SKYLAR LEIGH DRIVE BUFORD, GA 30518 | AFLAC | $11 | $0 | $11 | 0.03% |
| SCOTT A SMITH3 Filed as: SCOTT SMITH | 5300 OAKBROOK PKWY BLDG 300 SUITE 350 NORCROSS, GA 30093 | AFLAC | $9 | $0 | $9 | 0.03% |
| DEBORAH B SMITH3 | 5703 BRYNWOOD CIRCLE NW ACWORTH, GA 30101 | AFLAC | $5 | $0 | $5 | 0.01% |
| RYAN D HODGES3 | 4644 RIVER COURT PEACHTREE CORNERS, GA 30097 | AFLAC | $5 | $0 | $5 | 0.01% |
| JOHN MYERS3 | 81 GRAND MERIDEN FIRST CHESTERFIELD, MO 63005 | AFLAC | $4 | $0 | $4 | 0.01% |
| DUSTIN ROBERT JOHNSON3 Filed as: DUSTIN R JOHNSON | 50 HURT PLAZA SUITE 995-1630 ATLANTA, GA 30303 | AFLAC | $4 | $0 | $4 | 0.01% |
| STEVEN VORDERLANDWEHR3 | 1599 AMHEARST MILL DRIVE LAWRENCEVILLE, GA 30043 | AFLAC | $4 | $0 | $4 | 0.01% |
| WENDY M RANKIN3 Filed as: WENDY RANKIN | 114 BROAD STREET APT 201 ROME, GA 30161 | AFLAC | $4 | $0 | $4 | 0.01% |
| JOHN A BACON3 | 13716 PARKHILL OVERLAND PARK, KS 66221 | AFLAC | $3 | $0 | $3 | 0.01% |
| ALLISON FARRIS WENDELBERGER3 Filed as: ALLISON FARRIS WENDERLBERGER | 207 SANTE FE DRIVE WALNUT CREEK, CA 94598 | AFLAC | $2 | $0 | $2 | 0.01% |
| ANA MARIE GARCIA SMITH3 | 110 VANDERVIEW DRIVE SEYMOUR, TN 37865 | AFLAC | $1 | $0 | $1 | 0.00% |
| SUSAN REDDOCH BUFFINGTON3 | 400 TAX ROAD SHILOH, GA 31826 | AFLAC | $1 | $0 | $1 | 0.00% |
| JOHN A BACON3 | 11630 W 158TH TERRACE OVERLAND PARK, KS 66221 | AFLAC | $1 | $0 | $1 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ADMIN AMERICA, INC EIN 20-3581707 FSA ADMIN | Contract Administrator; Claims processing Service code 12 | 1720 WINDWARD CONCOURSE SUITE 290 ALPHARETTA, GA 30005 | $2K |
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 | 113 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 114 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HUMANA | 105 | $1.3M |
| Dental | HUMANA | 105 | $1.3M |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 113 | $182K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 113 | $182K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 113 | $182K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 113 | $215K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 113 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.