| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INSURANCE OFFICE OF AMERICA3 | 2839 PACES FERRY RD, STE 1200 ATLANTA, GA 30339 | COMPANION LIFE INSURANCE COMPANY | $46K | — | $46K | 15.00% |
| INSURANCE OFFICE OF AMERICA3 | 100 GALLERIA PKWY SE, STE 600 ATLANTA, GA 30339 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $17K | — | $17K | 10.00% |
| ELIZABETH SCHENK3 | 4725 SAND LAKE ROAD STE 300 ORLANDO, FL 32819 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 1.00% |
| ELIZABETH SCHENK | 4725 SAND LAKE ROAD STE 300 ORLANDO, FL 32819 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $10K | $10K | 16.00% |
| INSURANCE OFFICE OF AMERICA | 100 GALLERIA PARKWAY - SUITE 600 ATLANTA, GA 30339 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $9K | $0 | $9K | 15.00% |
| VOLUNTARY BENEFITS AT WORK | 1820 THE EXCHANGE SE - SUITE 750 ATLANTA, GA 30339 | TRUSTMARK INSURANCE COMPANY | $15K | — | $15K | 28.08% |
| INSURANCE OFFICE OF AMERICA Filed as: INSURANCE OFFICE OF AMERICA INC | 100 GALLERIA PARKWAY - SUITE 600 ATLANTA, GA 30339 | TRUSTMARK INSURANCE COMPANY | $15K | — | $15K | 28.08% |
| VOLUNTARY BENEFITS AT WORK | 1820 THE EXCHANGE SE - SUITE 750 ATLANTA, GA 30339 | TRUSTMARK INSURANCE COMPANY | $15K | — | $15K | 32.14% |
| INSURANCE OFFICE OF AMERICA Filed as: INSURANCE OFFICE OF AMERICA INC | 100 GALLERIA PARKWAY - SUITE 600 ATLANTA, GA 30339 | TRUSTMARK INSURANCE COMPANY | $15K | — | $15K | 32.14% |
| VOLUNTARY BENEFITS AT WORK | 1820 THE EXCHANGE SE - SUITE 750 ATLANTA, GA 30339 | TRUSTMARK INSURANCE COMPANY | $21K | — | $21K | 46.14% |
| INSURANCE OFFICE OF AMERICA | 100 GALLERIA PARKWAY - SUITE 600 ATLANTA, GA 30339 | TRUSTMARK INSURANCE COMPANY | $21K | — | $21K | 46.14% |
| INSURANCE OFFICE OF AMERICA | 100 GALLERIA PARKWAY - SUITE 600 ATLANTA, GA 30339 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $7K | — | $7K | 15.00% |
| ELIZABETH SCHENK | 4725 SAND LAKE ROAD STE 300 ORLANDO, FL 32819 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 4.00% |
| INSURANCE OFFICE OF AMERICA3 | 1855 W STATE RD 434 LONGWOOD, FL 32750 | NATIONAL VISION ADMINISTRATORS, LLC | $2K | — | $2K | 5.00% |
| BRIAN D ELY | 1820 THE EXCHANGE SE - SUITE 750 ATLANTA, GA 30339 | CONTINENTAL AMERICAN INSURANCE COMPANY | $9K | — | $9K | 29.55% |
| INSURANCE OFFICE OF AMERICA Filed as: INSURANCE OFFICE OF AMERICA INC | 1855 W STATE RD 434 LONGWOOD, FL 32750 | CONTINENTAL AMERICAN INSURANCE COMPANY | $9K | — | $9K | 29.55% |
| INSURANCE OFFICE OF AMERICA | 100 GALLERIA PARKWAY - SUITE 600 ATLANTA, GA 30339 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | 15.00% |
| ELIZABETH SCHENK | 4725 SAND LAKE ROAD STE 300 ORLANDO, FL 32819 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | — | $0 | 0.00% |
| INSURANCE OFFICE OF AMERICA Filed as: INSURANCE OFFICE OF AMERICA INC | 1855 W STATE RD 434 LONGWOOD, FL 32750 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $310 | $111 | $421 | 4.35% |
| USI INSURANCE SERVICES LLC Filed as: USI INSURANCE SERVICES NATIONAL INC | 3475 PIEDMONT ROAD STE 800 ATLANTA, GA 30305 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $399 | — | $399 | 4.12% |
| RJK & ASSOCIATES INC | 1800 PEACHTREE STREET NW ATLANTA, GA 30309 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $158 | $159 | $317 | 3.27% |
| ROBERT E FENN Filed as: ROBERT FENN | 179 LAKE LURE DR ALMA, GA 31510 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $308 | $5 | $313 | 3.23% |
| PLM SOLUTIONS INC | 557 GRAVES ROAD WEDOWEE, AL 36278 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $169 | $15 | $184 | 1.90% |
| BENEFIT COMMUNICATION SPECIALISTS | 37 W FAIRMONT AVE SAVANNAH, GA 31406 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $42 | $15 | $57 | 0.59% |
| KLD INSURANCE BENEFITS INC | 9085 BETHEL RD GAINESVILLE, GA 30506 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $53 | — | $53 | 0.55% |
| CHARLES D. BLOCK Filed as: CHARLES T FERGUSON | 859 SOUTHBRIDGE BLVD SAVANNAH, GA 31405 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $44 | — | $44 | 0.45% |
| CAROLE H WARREN | 1300 27TH PLACE SOUTH BIRMINGHAM, AL 35205 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $43 | — | $43 | 0.44% |
| B V STONE INC | 1800 SUNSET HARBOUR POINTE LAWRENCEVILLE, GA 30043 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $35 | — | $35 | 0.36% |
| ADVANCED BENEFIT SYSTEM INC | 145 RIVER LANDING DRIVE DANIEL ISLAND, SC 29492 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | $10 | $26 | 0.27% |
| CAROL PURDY FIELDS Filed as: CAROL FIELDS | 204 POTOMAC CT WOODSTOCK, GA 30188 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $25 | — | $25 | 0.26% |
| BURTON M HERRING JR Filed as: BURTON HERRING JR | 1135 ARLINGTON DR BIRMINGHAM, AL 35224 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17 | — | $17 | 0.18% |
| WILLIS TOWERS WATSON US LLC Filed as: WILLIS INSURANCE SERVICES OF GEORGI | 1 GLENLAKE PKWY FI 11 ATLANTA, GA 30328 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | — | $9 | 0.09% |
| BSK BENEFITS PLUS LLC | 205 PINECREST DR COVINGTON, LA 70433 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $0 | $0 | $0 | 0.00% |
| ELIZABETH SCHENK | 4725 SAND LAKE ROAD STE 300 ORLANDO, FL 32819 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $85 | — | $85 | 3.96% |
| INSURANCE OFFICE OF AMERICA | 100 GALLERIA PARKWAY - SUITE 600 ATLANTA, GA 30339 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | — | $0 | 0.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 3475 PIEDMONT ROAD STE 800 ATLANTA, GA 30305 | THE PAUL REVERE LIFE INSURANCE COMPANY | $7 | — | $7 | 8.54% |
| CAROLE H WARREN3 | 1300 27TH PLACE SOUTH BIRMINGHAM, AL 35205 | THE PAUL REVERE LIFE INSURANCE COMPANY | $3 | — | $3 | 3.66% |
| PLM SOLUTIONS INC3 | 557 GRAVES ROAD WEDOWEE, AL 36278 | THE PAUL REVERE LIFE INSURANCE COMPANY | $2 | — | $2 | 2.44% |
| KLD INSURANCE BENEFITS INC3 | 9085 BETHEL RD GAINESVILLE, GA 30506 | THE PAUL REVERE LIFE INSURANCE COMPANY | $1 | — | $1 | 1.22% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD HEALTHCARE EIN 58-1638390 | Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Claims processing; Float revenue; Contract Administrator Service code 12 | — | $250K |
| CORESOURCE, INC. EIN 35-1846036 | Plan Administrator; Claims processing; Other services Service code 12 | — | $107K |
| ANTHEM EIN 95-4331852 | Other services; Claims processing Service code 12 | — | $89K |
| INSURANCE OFFICE OF AMERICA INC EIN 59-2472656 | Insurance agents and brokers; Consulting (general) Service code 16 | — | $51K |
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 | 357 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 357 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | TRUSTMARK INSURANCE COMPANY | 205 | $77K |
| Dental | RELIANCE STANDARD LIFE INSURANCE COMPANY | 284 | $168K |
| Vision | NATIONAL VISION ADMINISTRATORS, LLC | 480 | $40K |
| Life insurance(4 contracts, 4 carriers) | TRUSTMARK INSURANCE COMPANY | 160 | $102K |
| Short-term disability(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 160 | $10K |
| Long-term disability(2 contracts, 2 carriers) | TRUSTMARK INSURANCE COMPANY | 127 | $83K |
| Stop-loss / reinsurancereinsurance | COMPANION LIFE INSURANCE COMPANY | 357 | $304K |
| Other(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 478 | $63K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 480 | — |
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.