| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | TOKIO MARINE - STOP LOSS GROUP | $22K | — | $22K | 5.17% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCCLENNAN AGENCY LLC | 11330 LAKEFIELD DR STE 100 BLDG 1 JOHNS CREEK, GA 30097 | ONE AMERICA | $7K | $4K | $12K | 21.58% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCCLENNAN AGENCY LLC | 11330 LAKEFIELD DR STE 100 BLDG 1 JOHNS CREEK, GA 30097 | ONE AMERICA | $6K | — | $6K | 15.00% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 70 WEST POINT, GA 31833 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | — | $2K | 9.39% |
| WILLIAM M WARDLAW JR3 | 187 CULVER ST LAWRENCEVILLE, GA 30046 | CONTINENTAL AMERICAN INSURANCE COMPANY | $17 | — | $17 | 0.07% |
| TEDDY LEE EARLES3 Filed as: TEDDY L EARLES | 394 TEAL COURT ROSWELL, GA 30076 | CONTINENTAL AMERICAN INSURANCE COMPANY | $17 | — | $17 | 0.07% |
| BRYCE A VAN RYN3 | 3053 RIVERVALE DR SW GRANDVILLE, MI 49418 | CONTINENTAL AMERICAN INSURANCE COMPANY | $13 | — | $13 | 0.06% |
| JEFFREY C WERNER3 | 18095 TRUDY DR SPRING LAKE, MI 49546 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3 | — | $3 | 0.01% |
| ERIC J CONDRON3 | 10880 SANDY OAK TRAIL CEDAR SPRINGS, MI 49319 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| WILLIAM M WARDLAW JR3 Filed as: WILLIAM M WARDLAW JR. | 187 S CULER ST LAWRENCEVILLE, GA 30046 | CONTINENTAL AMERICAN INSURANCE COMPANY | $0 | — | $0 | 0.00% |
| MARSH & MCLENNAN AGENCY LLC3 | 11330 LAKEFIELD DR BLDG 1 STE 100 DULUTH, GA 30097 | AMERITAS | $2K | $341 | $2K | 12.07% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH MCCLENNAN | 11330 LAKEFIELD DR STE 100 JOHNS CREEK, GA 30097 | ONE AMERICA | $1K | $280 | $2K | 12.27% |
| MARSH & MCLENNAN AGENCY LLC3 | 11330 LAKEFIELD DR STE 100 BLDG 1 DULUTH, GA 30097 | AMERITAS | $2K | $228 | $2K | 15.85% |
| MARSH & MCLENNAN AGENCY LLC3 | 11330 LAKEFIELD DR STE 100 BLDG 1 JOHNS CREEK, GA 30097 | ONE AMERICA | $1K | $204 | $1K | 18.01% |
| MARSH & MCLENNAN AGENCY LLC3 | 11330 LAKEFIELD DR STE 100 BLDG 1 JOHNS CREEK, GA 19406 | ONE AMERICA | $747 | $129 | $876 | 17.58% |
| LONG TERM CARE SOLUTIONS, INC.3 Filed as: LONG TERM CARE SOLUTIONS INC. | 14715 NE 95TH ST STE 200 REDMOND, WA 98052 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $355 | — | $355 | 11.25% |
| MARSH & MCLENNAN AGENCY LLC3 | 11330 LAKEFIELD DR BLDG 1 STE 100 JOHNS CREEK, GA 30097 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $118 | — | $118 | 3.74% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: J SMITH LANIER & CO | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $236 | — | $236 | 20.03% |
| MARSH & MCLENNAN AGENCY LLC3 | 11330 LAKEFIELD DR STE 100 BLDG 1 JOHNS CREE, GA 30097 | ONE AMERICA | $85 | $17 | $102 | 18.05% |
| AGENT ALLIANCE CORPORATION3 Filed as: NO AGENT LISTED | — | RXBENEFITS INC | — | $4K | $4K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| TRUSTMARK HEALTH BENEFITS INC EIN 35-1846036 ADMINISTRATOR | Other services; Plan Administrator; Claims processing Service code 12 | — | $190K |
| J SMITH LANIER EIN 36-1436000 BROKER | Insurance agents and brokers; Consulting (general) Service code 16 | — | $77K |
| ADVANCED MEDICAL PRICING SOLUTIONS EIN 20-2149357 ADMINISTRATOR | Plan Administrator; Other services; Claims processing Service code 12 | — | $51K |
| PHCS EIN 13-3068979 ADMINISTRATOR | Claims processing; Other services; Plan Administrator Service code 12 | — | $7K |
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 | 213 | 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) | 213 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AMERITAS | 166 | $11K |
| Vision | AMERITAS | 332 | $16K |
| Life insurance | ONE AMERICA | 246 | $7K |
| Short-term disability(2 contracts, 2 carriers) | ONE AMERICA | 38 | $14K |
| Long-term disability | ONE AMERICA | 111 | $54K |
| Prescription drug | RXBENEFITS INC | 210 | $0 |
| Stop-loss / reinsurancereinsurance | TOKIO MARINE - STOP LOSS GROUP | 212 | $422K |
| Other(5 contracts, 3 carriers) | ONE AMERICA | 246 | $70K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 332 | — |
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.