| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SVCS. | PO BOX 632886 CINCINNATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $0 | $4K | 6.48% |
| LOCKTON COMPANIES, LLC3 | PO BOX 123042 DALLAS, TX 75312 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $0 | $2K | 3.52% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SVCS. | PO BOX 632886 CINCINNATI, OH 45263 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $556 | $0 | $556 | 4.32% |
| COLONIAL LIFE BROKERAGE LLC3 Filed as: COLONIAL LIFE BROKERAGE AND VARIOUS | 12010 BROOKFIELD CLUB ROAD ROSWELL, GA 30075 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $335 | $37 | $372 | 2.89% |
| KLD INSURANCE BENEFITS INC3 Filed as: KLD INSURANCE BENEFITS INC. | 9085 BETHEL ROAD GAINESVILLE, GA 30506 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $199 | $24 | $223 | 1.73% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY ATLANTA, GA 30339 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $164 | $0 | $164 | 1.28% |
| VINSON K ELLENBERG3 Filed as: VINSON K. ELLENBERG | 905 ADAIR AVENUE NE ATLANTA, GA 30306 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $157 | $3 | $160 | 1.24% |
| NORTH FLORIDA BENEFIT SOLUTIONS INC3 | 12659 1 PLUMMER GRANT ROAD JACKSONVILLE, FL 32258 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $95 | $9 | $104 | 0.81% |
| SHERI L MITCHELL INC3 Filed as: SHERI L. MITCHELL INC. | 540 BIRNAMWOOD DRIVE SUWANEE, GA 30024 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $93 | $0 | $93 | 0.72% |
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 | 164 | 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) | 164 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 164 | $54K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 164 | $54K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 164 | $54K |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 164 | $67K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 164 | — |
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.