| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFIT SPECIALIST GRP INC | 106 7TH ST N SUITE C CORDELE, GA 31015 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 2.73% |
| MGNMRB INC | 225 MARINA DR ST SIMONS ISLAND, GA 315222243 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 2.73% |
| BENEFIT SPECIALIST GRP INC | 106 7TH ST N SUITE C CORDELE, GA 31015 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 7.06% |
| BROOME AGENCY INC | 1213 BAYTREE RD VALDOSTA, GA 31602 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $553 | — | $553 | 1.99% |
| WILLIAM HAROLD OWENS | ATTN ANGIE JACOBS P.O. BOX 997 CORDELE, GA 31010 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $89 | — | $89 | 0.32% |
| BENEFIT SPECIALIST GRP INC | 106 7TH ST N SUITE C CORDELE, GA 31015 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3K | — | $3K | 15.50% |
| BROOME AGENCY INC | 1213 BAYTREE RD VALDOSTA, GA 31602 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 4.65% |
| WILLIAM HAROLD OWENS | ATTN ANGIE JACOBS P.O. BOX 997 CORDELE, GA 31010 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $84 | — | $84 | 0.38% |
| BENEFIT SPECIALIST GRP INC | 106 7TH ST N SUITE C CORDELE, GA 31015 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 7.53% |
| BROOME AGENCY INC | 1213 BAYTREE RD VALDOSTA, GA 31602 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $542 | — | $542 | 2.45% |
| WILLIAM HAROLD OWENS | ATTN ANGIE JACOBS P.O. BOX 997 CORDELE, GA 31010 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $58 | — | $58 | 0.26% |
| BENEFIT SPECIALISTS INC. Filed as: BENEFIT SPECIALISTS GRP INC | 106 7TH ST N SUITE C CORDELE, GA 31015 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 9.89% |
| BROOME AGENCY INC | 1213 BAYTREE RD VALDOSTA, GA 31602 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $278 | — | $278 | 2.61% |
| WILLIAM HAROLD OWENS | ATTN ANGIE JACOBS P.O. BOX 997 CORDELE, GA 31010 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $31 | — | $31 | 0.29% |
| BENEFIT SPECIALIST GRP INC | 106 7TH ST N SUITE C CORDELE, GA 31015 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 12.64% |
| BROOME AGENCY INC | 1213 BAYTREE RD VALDOSTA, GA 31602 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $337 | — | $337 | 3.20% |
| WILLIAM HAROLD OWENS | ATTN ANGIE JACOBS P.O. BOX 997 CORDELE, GA 31010 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $25 | — | $25 | 0.24% |
| BENEFIT SPECIALIST GRP INC | 106 7TH ST N SUITE C CORDELE, GA 31015 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $363 | — | $363 | 6.85% |
| BROOME AGENCY INC | 1213 BAYTREE RD VALDOSTA, GA 31602 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $119 | — | $119 | 2.25% |
| WILLIAM HAROLD OWENS | ATTN ANGIE JACOBS P.O. BOX 997 CORDELE, GA 31010 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $12 | — | $12 | 0.23% |
| MARSH & MCLENNAN AGENCY LLC Filed as: J. SMITH LANIER & COMPANY | 600 MEMORIAL DRIVE WAYCROSS, GA 31501 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $146 | — | $146 | 3.38% |
| BENEFIT SPECIALIST GRP INC | 106 7TH ST N SUITE C CORDELE, GA 31015 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $186 | — | $186 | 5.47% |
| BROOME AGENCY INC | 1213 BAYTREE RD VALDOSTA, GA 31602 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $71 | — | $71 | 2.09% |
| WILLIAM HAROLD OWENS | ATTN ANGIE JACOBS P.O. BOX 997 CORDELE, GA 31010 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $7 | — | $7 | 0.21% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PARAGON BENEFITS, INC. EIN 58-1741732 THIRD PARTY ADMINISTRATOR | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Claims processing Service code 12 | 6065 BUSINESS PARK DRIVE COLUMBUS, GA 31909 | $40K |
| CURALINC LLC EIN 33-1206383 NO BLUE DAY | Claims processing Service code 12 | 8707 SKOKIE BLVD SUITE 109 SKOKIE, IL 60077 | $3K |
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 | 0 | 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) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PARAGON BENEFITS, INC. | 0 | $744K |
| Dental | RELIANCE STANDARD LIFE INSURANCE COMPANY | 244 | $42K |
| Life insurance(2 contracts, 2 carriers) | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 40 | $15K |
| Short-term disability | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 36 | $11K |
| Long-term disability | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 68 | $28K |
| Stop-loss / reinsurancereinsurance | STOP LOSS INSURANCE SERVICES | 0 | $363K |
| Other(4 contracts) | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 67 | $53K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 244 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.