| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | ATTN GEORGIA PO BOX 62819 VIRGINIA BEACH, VA 23466 | STANDARD INSURANCE COMPANY | $72K | $0 | $72K | 14.95% |
| VALENT GROUP3 Filed as: VALENT GROUP LLC | SUITE 120 3500 BLUE LAKE ROAD VESTAVIA, AL 35243 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $40K | $0 | $40K | 12.31% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 200 GALLERIA PKWY STE 1950 ATLANTA, GA 30339 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $17K | $0 | $17K | 5.40% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $72 | $72 | 0.02% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $12 | $12 | 0.00% |
| 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 ADMINISTRATION | Other services; Float revenue; Contract Administrator; Named fiduciary; Non-monetary compensation; Claims processing; Participant communication; Direct payment from the plan Service code 12 | — | $168K |
| PALMER AND CAY LLC BROKER | Insurance agents and brokers Service code 22 | — | $84K |
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 | 403 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 406 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | GUARDIAN | 319 | $333K |
| Vision | EYEMED VISION CARE | 454 | $27K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 402 | $324K |
| Long-term disability | STANDARD INSURANCE COMPANY | 369 | $480K |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 406 | $327K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 454 | — |
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.