| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | P.O. BOX 201503 DALLAS, TX 75320 | UNION SECURITY INSURANCE COMPANY | $131K | $514 | $131K | 5.39% |
| THE DOWNEY GROUP INC3 Filed as: THE DOWNEY GROUP | P.O. BOX 1460 CHAMPAIGN, IL 618241460 | PACIFIC LIFE INSURANCE COMPANY | $16K | $0 | $16K | 2.59% |
| LAWTON MACD NEASE III3 | 2100 RIVEREDGE PARKWAY STE 200 ATLANTA, GA 30328 | PACIFIC LIFE INSURANCE COMPANY | $11K | $0 | $11K | 1.73% |
| WELLS FARGO INSURANCE SERVICES3 | 3475 PIDEMONT ROAD NE STE 800 ATLANTA, GA 30305 | VISION SERVICE PLAN | $4K | $0 | $4K | 2.06% |
| M. FINANCIAL HOLDINGS INCORPORATED3 Filed as: M HOLDING SECURITIES | P.O. BOX 9190 DES MOINES, IA 50306 | SECURITY LIFE OF DENVER INSURANCE COMPANY | $234 | $0 | $234 | 0.14% |
| ENTERPRISES SECURITY GROUP3 | P.O. BOX 9190 DES MOINES, IA 50306 | SECURITY LIFE OF DENVER INSURANCE COMPANY | $18 | $0 | $18 | 0.01% |
| WELLS FARGO INSURANCE SERVICES3 | 3475 PIEDMONT ROAD NE STE 800 ATLANTA, GA 30305 | PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY | $5K | $213 | $6K | 3.38% |
| WELLS FARGO INSURANCE SERVICES3 | 25 BULL SGTREET SAVANNAH, GA 31401 | PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY | $357 | $0 | $357 | 0.22% |
| GEORGE REYNOLDS III ET AL3 Filed as: GEORGE REYNOLDS, III ET AL | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $12K | $0 | $12K | 11.25% |
| WELLS FARGO INSURANCE SERVICES3 | 3475 PIEDMONT ROAD NE STE 800 ATLANTA, GA 30305 | PROVIDENT LIFE & ACCIDENT INSURANCE | $4K | $662 | $5K | 6.18% |
| WELLS FARGO INSURANCE SERVICES3 | 25 BULL STREET SAVANNAH, GA 31401 | PROVIDENT LIFE & ACCIDENT INSURANCE | $333 | $0 | $333 | 0.44% |
| WELLS FARGO INSURANCE SERVICES3 | 100 MAIN STREET WINSTON-SALEM, NC 27150 | PROVIDENT LIFE & ACCIDENT INSURANCE | $12 | $0 | $12 | 0.02% |
| LISA MCDANIEL3 Filed as: LISA F MCDANIEL, ET AL | 2801 DEVINE STREET COLUMBIA, SC 29205 | CONTINENTAL AMERICAN INSURANCE COMPANY | $13K | $0 | $13K | 18.83% |
| WELLS FARGO INSURANCE SERVICES3 | 3475 PIEDMONT ROAD NE STE 800 ATLANTA, GA 30305 | UNUM LIFE INSURANCE COMPANY | $3K | $0 | $3K | 4.93% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 3475 PIEDMONT ROAD NE STE 800 ATLANTA, GA 30305 | UNUM LIFE INSURANCE COMPANY | $4K | $0 | $4K | 8.46% |
| WELLS FARGO INSURANCE SERVICES3 | P.O. BOX 601478 CHARLOTTE, NC 282601478 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $6K | $0 | $6K | 12.60% |
| ONE SOURCE BROKERAGE, INC.3 Filed as: ONE SOURCE BROKERAGE INC. | 3155 MIDTOWN PARK SOUTH MOBILE, AL 36606 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 2.40% |
| WELLS FARGO INSURANCE SERVICES3 | 3475 PIEDMONT ROAD NE STE 800 ATLANTA, GA 30305 | PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY | $1K | $181 | $1K | 5.83% |
| WELLS FARGO INSURANCE SERVICES3 | 25 BULL STREET SAVANNAH, GA 31401 | PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY | $302 | $0 | $302 | 1.23% |
| WELLS FARGO INSURANCE SERVICES3 | 3475 PIEDMONT ROAD NE STE 800 ATLANTA, GA 30305 | PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY | $397 | $0 | $397 | 2.91% |
| WELLS FARGO INSURANCE SERVICES3 | 100 N MAIN STREET WINSTON-SALEM, NC 27150 | PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY | $60 | $0 | $60 | 0.44% |
| WELLS FARGO INSURANCE SERVICES | 3475 PIEDEMONT ROAD NE STE 800 ATLANTA, GA 30305 | ZURICH AMERICAN INSURANCE COMPANY | $1K | $0 | $1K | 10.00% |
| WELLS FARGO INSURANCE SERVICES3 | 34I75 PIEDMONT ROAD NE STE 800 ATLANTA, GA 30305 | PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY | $837 | $0 | $837 | 14.05% |
| ROBERT NECESSARY3 | 1278 AVIANO DRIVE NAPLES, FL 34105 | PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY | $18 | $0 | $18 | 0.30% |
| STEPHEN WHITE ET AL3 Filed as: STEPHEN WHITE, ET AL | 214 25 42ND AVE 4TH FLOOR BAYSIDE, NY 11361 | AFLAC | $612 | $0 | $612 | 10.89% |
| WELLS FARGO INSURANCE SERVICES3 | 3475 PIEDMONT ROAD NE STE 800 ATLANTA, GA 30305 | PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY | $242 | $0 | $242 | 5.61% |
| WELLS FARGO INSURANCE SERVICES3 | 25 BULL STREET SAVANNAH, GA 31401 | PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY | $86 | $0 | $86 | 1.99% |
| WELLS FARGO INSURANCE SERVICES3 | 100 MAIN STREET WINSTON-SALEM, NC 27150 | PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY | $39 | $0 | $39 | 0.90% |
| WELLS FARGO INSURANCE SERVICES3 | 26 BULL STREET SAVANNAH, GA 31401 | PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY | $51 | $0 | $51 | 3.51% |
| WELLS FARGO INSURANCE SERVICES3 | 3475 PIEDMONT ROAD NE STE 800 ATLANTA, GA 30305 | PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY | $20 | $0 | $20 | 1.37% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX INC EIN 33-0044120 PHARMACY BENEFIT MGT | Other fees; Float revenue; Claims processing; Direct payment from the plan Service code 12 | 2300 MAIN SGTREET IRVINE, CA 92614 | $3.5M |
| UMR INC EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | P.O. BOX 30541 SALT LAKE CITY, UT 841300541 | $1.2M |
| WELLS FARGO INSURANCE COMPANY EIN 55-1882208 BROKER | Other commissions Service code 55 | 301 S COLLEGE STREET 19TH FLOOR CHARLOTTE, NC 282026000 | $229K |
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 | 1,592 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 22 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,614 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | SECURITY LIFE OF DENVER INSURANCE COMPANY | 1 | $172K |
| Vision | VISION SERVICE PLAN | 1,027 | $185K |
| Life insurance(3 contracts, 3 carriers) | UNION SECURITY INSURANCE COMPANY | 1,556 | $3.1M |
| Long-term disability | UNION SECURITY INSURANCE COMPANY | 1,556 | $2.4M |
| Stop-loss / reinsurancereinsurance | NATIONAL UNION FIRE INSURANCE COMPANY | 139 | $1.2M |
| Other(15 contracts, 8 carriers) | PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY | 1,600 | $729K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,600 | — |
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."
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.