| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVIES NATIONAL LLC | PO BOX 601478 CHARLOTTE, NC 28260 | STANDARD INSURANCE COMPANY | $72K | $0 | $72K | 14.58% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PALMER & CAY LLC | 3050 PEACHTREE RD NW STE 475 ATLANTA, GA 30305 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $32 | $32 | 0.01% |
| VALENT GROUP3 Filed as: VALENT GROUP LLC | 3600 BLUE LAKE ROAD SUITE 120 VESTAVIA, AL 35243 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $48K | $0 | $48K | 15.96% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 400 GALLERIA PKWY SUITE 1950 ATLANTA, GA 30339 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $12K | $0 | $12K | 4.03% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $140 | $140 | 0.05% |
| YATES LLC3 Filed as: YATES INSURANCE AGENCY | 2800 CENTURY PKWY NE #300 ATLANTA, GA 30345 | FEDERAL INSURANCE COMPANY | $472 | $0 | $472 | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 CLAIMS ADMINISTRATOR | Other services; Float revenue; Direct payment from the plan; Contract Administrator; Participant communication; Named fiduciary; Claims processing; Non-monetary compensation Service code 12 | — | $264K |
| PALMER AND CAY LLC BROKER | Insurance agents and brokers Service code 22 | — | $91K |
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 | 401 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 402 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 621 | $407K |
| Vision | EYEMED VISION CARE | 436 | $30K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 402 | $300K |
| Long-term disability | STANDARD INSURANCE COMPANY | 368 | $496K |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 402 | $303K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 621 | — |
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.