| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CORESOURCE, INC.3 Filed as: TRUSTMARK HEALTH BENEFITS | — | BERKLEY | $7K | — | $7K | 2.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN | 611 POINT NORTH BOULEVARD ALBANY, GA 31721 | GUARDIAN | $12K | $3K | $14K | 15.78% |
| BENEFIT SPECIALISTS INC.3 Filed as: BENEFIT SPECIALISTS GROUP, INC. | 106 7TH STREET N SUITE C CORDELE, GA 31015 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3K | — | $3K | 16.66% |
| BROOME AGENCY INC3 Filed as: BROOME AGENCY, INC. | 1213 BAYTREE RD VALDOSTA, GA 31602 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 6.88% |
| OWENS WILLIAM HAROLD3 | ATTEN ANGIE JACOBS PO BOX 1002 CORDELE, GA 31010 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $143 | — | $143 | 0.69% |
| WHITE JANE3 | PO BOX 5766 CORDELE, GA 31010 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $6K | — | $6K | 40.09% |
| BROOME AGENCY INC3 Filed as: BROOME AGENCY, INC. | 1213 BAYTREE RD VALDOSTA, GA 31602 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 16.37% |
| BENEFIT SPECIALISTS INC.3 Filed as: BENEFIT SPECIALISTS GROUP, INC. | 106 7TH STREET N SUITE C CORDELE, GA 31015 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $147 | — | $147 | 0.97% |
| OWENS WILLIAM HAROLD3 | ATTEN ANGIE JACOBS PO BOX 1002 CORDELE, GA 31010 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $8 | — | $8 | 0.05% |
| BENEFIT SPECIALISTS INC.3 Filed as: BENEFIT SPECIALISTS GROUP, INC. | 106 7TH STREET N SUITE C CORDELE, GA 31015 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $325 | — | $325 | 2.18% |
| BROOME AGENCY INC3 Filed as: BROOME AGENCY, INC. | 1213 BAYTREE RD VALDOSTA, GA 31602 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $79 | — | $79 | 0.53% |
| OWENS WILLIAM HAROLD3 | ATTEN ANGIE JACOBS PO BOX 1002 CORDELE, GA 31010 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $23 | — | $23 | 0.15% |
| BENEFIT SPECIALISTS INC.3 Filed as: BENEFIT SPECIALISTS GROUP, INC. | 106 7TH STREET N SUITE C CORDELE, GA 31015 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 10.55% |
| BROOME AGENCY INC3 Filed as: BROOME AGENCY, INC. | 1213 BAYTREE RD VALDOSTA, GA 31602 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $580 | — | $580 | 4.37% |
| OWENS WILLIAM HAROLD3 | ATTEN ANGIE JACOBS PO BOX 1002 CORDELE, GA 31010 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $54 | — | $54 | 0.41% |
| BENEFIT SPECIALISTS INC.3 Filed as: BENEFIT SPECIALISTS GROUP, INC. | 106 7TH STREET N SUITE C CORDELE, GA 31015 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 14.24% |
| BROOME AGENCY INC3 Filed as: BROOME AGENCY, INC. | 1213 BAYTREE RD VALDOSTA, GA 31602 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $448 | — | $448 | 5.86% |
| OWENS WILLIAM HAROLD3 | ATTEN ANGIE JACOBS PO BOX 1002 CORDELE, GA 31010 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $34 | — | $34 | 0.45% |
| BENEFIT SPECIALISTS INC.3 Filed as: BENEFIT SPECIALISTS GROUP, INC. | 106 7TH STREET N SUITE C CORDELE, GA 31015 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $221 | — | $221 | 9.44% |
| BROOME AGENCY INC3 Filed as: BROOME AGENCY, INC. | 1213 BAYTREE RD VALDOSTA, GA 31602 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $87 | — | $87 | 3.71% |
| OWENS WILLIAM HAROLD3 | ATTEN ANGIE JACOBS PO BOX 1002 CORDELE, GA 31010 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $9 | — | $9 | 0.38% |
| BENEFIT SPECIALISTS INC.3 Filed as: BENEFIT SPECIALISTS GROUP, INC. | 106 7TH STREET N SUITE C CORDELE, GA 31015 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $120 | — | $120 | 8.46% |
| BROOME AGENCY INC3 Filed as: BROOME AGENCY, INC. | 1213 BAYTREE RD VALDOSTA, GA 31602 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $46 | — | $46 | 3.24% |
| OWENS WILLIAM HAROLD3 | ATTEN ANGIE JACOBS PO BOX 1002 CORDELE, GA 31010 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $5 | — | $5 | 0.35% |
No Schedule C service providers reported on this filing.
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 | 159 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 159 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BERKLEY | 115 | $353K |
| Dental | GUARDIAN | 159 | $91K |
| Vision | GUARDIAN | 159 | $91K |
| Life insurance(3 contracts, 2 carriers) | GUARDIAN | 159 | $121K |
| Short-term disability(2 contracts, 2 carriers) | GUARDIAN | 159 | $99K |
| Long-term disability | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 48 | $21K |
| Stop-loss / reinsurancereinsurance | BERKLEY | 115 | $353K |
| Other(3 contracts) | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 46 | $30K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 159 | — |
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.