| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS. SVCS., INC. | PO BOX 632886 CINCINNATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 10.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS. SVCS., INC. | PO BOX 632886 CINCINNATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 10.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $542 | $4 | $546 | 4.38% |
| AMITA P. PATEL3 | 4450 CARVER COURT CUMMING, GA 30024 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | $512 | $523 | 4.19% |
| KLD INSURANCE BENEFITS INC3 Filed as: KLD INSURANCE BENEFITS, INC. | 9085 BETHEL ROAD GAINSVILLE, GA 30506 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $158 | $41 | $199 | 1.60% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: NORTHWESTERN BENEFIT CORP. OF GA | 3438 PEACHTREE RD. PHILLIPS TOWER, SUITE 1100 ATLANTA, GA 30326 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $137 | — | $137 | 1.10% |
| VINSON K ELLENBERG3 Filed as: VINSON K. ELLENBERG | 905 ADAIR AVE. NE ATLANTA, GA 30306 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $126 | $6 | $132 | 1.06% |
| SHERI L MITCHELL INC3 | 540 BIRNAMWOOD DRIVE SUWANEE, GA 30024 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $107 | $3 | $110 | 0.88% |
| C MARIA ADAMS VOLK3 | 2295 OLD ORCHARD DRIVE MARIETTA, GA 30068 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $79 | $19 | $98 | 0.79% |
| DORIS REBECCA BOWDEN3 | 400 VILLAGE PARKWAY ATLANTA, GA 30306 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $77 | $20 | $97 | 0.78% |
| MARY KAITLIN MILLER3 | 1323 INVERNES COVE DRIVE BIRMINGHAM, AL 35124 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $56 | — | $56 | 0.45% |
| NORMAC SOLUTIONS INC3 Filed as: NORMAC SOLUTIONS, INC. | 3730 EVEREST DR. MONTGOMERY, AL 36106 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $35 | — | $35 | 0.28% |
| MARIA VERONICA JARQUE3 | 8366 VIA SONOMA, UNIT E LA JOLLA, CA 92037 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $24 | $3 | $27 | 0.22% |
| KENNETH B TORBETT3 | 453 BRUSHSTROKE CT MARIETTA, GA 30067 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17 | — | $17 | 0.14% |
| BARBARA J LAKE3 | 226 N HIGH ST MORRISTOWN, IN 46161 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | $1 | $9 | 0.07% |
| DANA MARIE MOWATT3 | 23701 S. WESTERN AVENUE #112 TORRANCE, CA 90501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.06% |
| LAURIE J BURNS3 Filed as: LAURIE J. BURNS | 303 PLYLER RD. INDIAN TRAIL, NC 28079 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.03% |
| LESLIE BUSSEY3 | PO BOX 725385 ATLANTA, GA 31139 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.03% |
| DEBRA E RUSSELL3 Filed as: DEBRA D. RUSSELL | 129 COLONIAL STREET SE PORT CHARLOTTE, FL 33952 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.02% |
| SPECTRUM SOLUTIONS INC3 Filed as: SPECTRUM SOLUTIONS, INC. | 213 GOVERNOR WALK KATHLEEN, GA 31047 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.02% |
| JAKORP INC3 | P.O. BOX 27207 SAN DIEGO, CA 92127 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.01% |
| MICHAEL C WALKER3 Filed as: MICHAEL J. MINNEY | P.O. BOX 365 POWAY, CA 92074 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.01% |
| JEFFREY D BRINDLE3 Filed as: JEFFREY D. BRINDLE | 10811 LAKEVIEW DRIVE CARMEL, IN 46033 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.01% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $659 | — | $659 | 10.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS. SVCS., INC. | PO BOX 632886 CINCINNATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $219 | — | $219 | 9.99% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $99 | — | $99 | 4.81% |
| AMITA P. PATEL3 | 4450 CARVER COURT CUMMING, GA 30040 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $38 | $39 | 1.89% |
| KDL INSURANCE BENEFITS, INC.3 | 9085 BETHEL ROAD GAINSVILLE, GU 30506 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $35 | $3 | $38 | 1.85% |
| VINSON K ELLENBERG3 | 905 ADAIR AVE NE ATLANTA, GA 30306 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $34 | $1 | $35 | 1.70% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: NORTHWESTERN BENEFITS CORP. OF GA | 3438 PEACHTREE RD. NE PHILLIPS TOWER, SUITE 1100 ATLANTA, GA 30326 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $34 | — | $34 | 1.65% |
| SHERI L MITCHELL INC3 | 540 BIRNAMWOOD DRIVE SUWANEE, GA 30024 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $24 | — | $24 | 1.17% |
| C MARIE ADAMS VOLK3 | 2295 OLD ORCHARD DRIVE MARIETTA, GA 30068 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | $2 | $18 | 0.87% |
| NORMAC SOLUTIONS INC3 Filed as: NORMAC SOLUTIONS, INC. | 3730 EVEREST DR. MONTGOMERY, AL 36106 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | — | $9 | 0.44% |
| DORIS REBECCA BOWDEN3 | 400 VILLAGE PARKWAY ATLANTA, GA 30306 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $1 | $5 | 0.24% |
| KENNETH B TORBETT3 | 453 BRUSHSTROKE CT MARIETTA, GA 30067 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.19% |
| MARIA VERONICA JARQUE3 | 4085 NOBEL DR #29 SAN DIEGO, CA 92122 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.10% |
| LESLIE BUSSEY3 | P.O. BOX 725385 ATLANTA, GA 31139 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.05% |
| DEBRA E RUSSELL3 | 129 COLONIAL STREET SE PORT CHARLOTTE, FL 33952 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.05% |
| LAURIE J BURNS3 | 303 PLYLER RD INDIAN TRAIL, NC 28079 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.05% |
| BARBARA J LAKE3 | 226 N HIGH ST MORRISTOWN, IN 46161 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.05% |
| DANA MARIE MOWATT3 | 23701 S. WESTERN AVENUE #112 TORRANCE, CA 90501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.05% |
| SPECTRUM SOLUTIONS INC3 | 213 GOVERNOR WALK KATHLEEN, GA 31047 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.05% |
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 | 167 | 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) | 167 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 167 | $25K |
| Short-term disability(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 40 | $19K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 167 | $17K |
| Other(3 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 167 | $30K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 167 | — |
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.