| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PRITCHARD & JERDEN INC3 | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $57K | $0 | $57K | 10.32% |
| PRITCHARD & JERDEN INC3 | 950 E PACES FERRY RD STE 2000 ATLANTA, GA 303261384 | PRINCIPAL LIFE INSURANCE COMPANY | $26K | $7K | $33K | 14.26% |
| GARRY L JOHNSON & ASSOCIATES INC3 Filed as: GARRY L JOHNSON | 3850 E BASELINE RD STE 121 MESA, AZ 852064404 | PRINCIPAL LIFE INSURANCE COMPANY | $5K | $0 | $5K | 2.01% |
| DANIEL E ZECKMAN3 | 1275 SHILOH RD NW STE 2260 KENNESAW, GA 30144 | AFLAC | $803 | $62 | $865 | 6.51% |
| RODNEY A MCCLURE3 | 606 REDBUD TER CANTON, GA 30115 | AFLAC | $181 | $0 | $181 | 1.36% |
| JOHN P KOWN II3 | 430 DAVIS CARNES LN NW MARIETTA, GA 30064 | AFLAC | $115 | $10 | $125 | 0.94% |
| DAVID C CLOUD JR3 | 12 TRENT DR SE ROME, GA 30161 | AFLAC | $88 | $0 | $88 | 0.66% |
| THOMAS ROBERT GIDDENS3 | P.O. BOX 2517 KENNESAW, GA 30156 | AFLAC | $41 | $0 | $41 | 0.31% |
| ROBERT HESLEP3 | 6680 RIVER ISLAND CIR BUFORD, GA 30518 | AFLAC | $23 | $0 | $23 | 0.17% |
| ROBERT F LANSFORD3 | 5018 AMBER WAY NW ACWORTH, GA 30102 | AFLAC | $14 | $0 | $14 | 0.11% |
| ROBERT L GOBLE3 | 250 34TH AVE NE HICKORY, NC 28601 | AFLAC | $14 | $0 | $14 | 0.11% |
| PAUL SHELBY AMOS II3 | 6801 RIVER RD STE 2100 COLUMBUS, GA 31904 | AFLAC | $7 | $0 | $7 | 0.05% |
| CHRISTIE MARZARI3 Filed as: CHRISTIE M MARZARI | 1932 WYNNTON RD COLUMBUS, GA 31999 | AFLAC | $4 | $0 | $4 | 0.03% |
| LANCE OSBORNE3 | 21822 SEACREST LN HUNTINGTON BEACH, CA 92646 | AFLAC | $4 | $0 | $4 | 0.03% |
| DEBORAH B SMITH3 | 5703 BRYNWOOD CIR NW ACWORTH, GA 30101 | AFLAC | $3 | $0 | $3 | 0.02% |
| RONALD S SANDERS3 | 744 E DENIM TRL SAN TAN VALLEY, AZ 85143 | AFLAC | $3 | $0 | $3 | 0.02% |
| AMY A O SHIELDS3 | 5159 CALGARY DR DOUGLASVILLE, GA 30135 | AFLAC | $2 | $0 | $2 | 0.02% |
| JONATHAN W MCCUTCHEON3 | 1150 MALLARD LAKE DR BOGART, GA 30622 | AFLAC | $1 | $0 | $1 | 0.01% |
| ALLISON FARRIS WENDELBERGER3 | 207 SANTA FE DR WALNUT CREEK, GA 94598 | AFLAC | $1 | $0 | $1 | 0.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INS CO EIN 59-1031071 SERVICE PROVIDER | Other services; Participant communication; Direct payment from the plan; Claims processing; Non-monetary compensation; Float revenue; Named fiduciary; Contract Administrator Service code 12 | — | $2K |
| CIGNA | Float revenue; Other services; Claims processing; Non-monetary compensation; Direct payment from the plan; Participant communication; Named fiduciary; Contract Administrator Service code 12 | — | $0 |
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 | 110 | 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) | 110 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 115 | $549K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 171 | $229K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 171 | $229K |
| Life insurance(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 171 | $242K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 171 | $229K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 171 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.