| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAVEN BENEFITS | 1000 PEACHTREE INDUSTRIAL BLVD SUWANEE, GA 30024 | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA | $73K | — | $73K | 4.38% |
| HAVEN BENEFITS Filed as: HAVEN BENEFITS INC | 1000 PEACHTREE INDUSTRIAL BLVD SUWANEE, GA 30024 | CIGNA | $42K | — | $42K | 7.57% |
| HAVEN BENEFITS | 1000 PEACHTREE INDUSTRIAL BLVD STE 6437 SUWANEE, GA 30024 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $41K | — | $41K | 13.85% |
| MJ INSURANCE Filed as: VARIOUS AGENTS | 2144 HILTON DRIVE GAINESVILLE, GA 30501 | AFLAC | $2K | — | $2K | 11.49% |
| HAVEN BENEFITS | 1000 PEACHTREE INDUSTRIAL BLVD SUITE 6347 SUWANEE, GA 30024 | CONTINENTAL AMERICAN INSURANCE COMPANY | $639 | — | $639 | 4.70% |
| SHARON D ROBERTS | PO BOX 1129 YOUNG HARRIS, GA 30582 | CONTINENTAL AMERICAN INSURANCE COMPANY | $107 | — | $107 | 0.79% |
| GLORIA E CAMP | 235 CAMP DR RD TOCCOA, GA 30577 | CONTINENTAL AMERICAN INSURANCE COMPANY | $98 | — | $98 | 0.72% |
| JOHN B ALLEN III | 140 AZURE BAY COURT CHAPIN, SC 29036 | CONTINENTAL AMERICAN INSURANCE COMPANY | $77 | — | $77 | 0.57% |
| DEJUAN B MARTIN | 6600 SHOAL CREEK RD CLERMONT, GA 30527 | CONTINENTAL AMERICAN INSURANCE COMPANY | $70 | — | $70 | 0.51% |
| TERRIE N ALLISON | 1071 STANSEL RD CLEVELAND, GA 30528 | CONTINENTAL AMERICAN INSURANCE COMPANY | $65 | — | $65 | 0.48% |
| DEREK B DAVIS | 2649 OCEAN HWY N SHALLOTTE, NC 28470 | CONTINENTAL AMERICAN INSURANCE COMPANY | $64 | — | $64 | 0.47% |
| DAVID H JEFFORDS | PO BOX 14132 FLORENCE, SC 29504 | CONTINENTAL AMERICAN INSURANCE COMPANY | $57 | — | $57 | 0.42% |
| WILLIS TOWERS WATSON US LLC Filed as: WILLIS L BROWN II | 3040 HWY 76 E SUITE C MULLINS, SC 29574 | CONTINENTAL AMERICAN INSURANCE COMPANY | $51 | — | $51 | 0.38% |
| RONALD E KIRKLAND | 4 SOTHEBY PL SE GURLEY, AL 35748 | CONTINENTAL AMERICAN INSURANCE COMPANY | $42 | — | $42 | 0.31% |
| CHARLES F GREER | 2888 ALOMA LAKE RUN OVIEDO, FL 32765 | CONTINENTAL AMERICAN INSURANCE COMPANY | $29 | — | $29 | 0.21% |
| JOHN D TYLER | 130 DUCK HAWK WAY MARIETTA, SC 29661 | CONTINENTAL AMERICAN INSURANCE COMPANY | $28 | — | $28 | 0.21% |
| SCOTT A SMITH | 5300 OAKBROOK PARKWAY NORCROSS, GA 30093 | CONTINENTAL AMERICAN INSURANCE COMPANY | $25 | — | $25 | 0.18% |
| BENEFITS CONSULTING GROUP | 5729 FAIRWOOD DR ACWORTH, GA 30101 | CONTINENTAL AMERICAN INSURANCE COMPANY | $23 | — | $23 | 0.17% |
| JUSTIN M GUIDI | 555 N PLEASANT BURG DR SUITE 200 GREENVILLE, SC 29607 | CONTINENTAL AMERICAN INSURANCE COMPANY | $23 | — | $23 | 0.17% |
| WILLIAM WARDLAW JR | 368 WEST PIKE ST STE 207 LAWRENCEVILLE, GA 30046 | CONTINENTAL AMERICAN INSURANCE COMPANY | $15 | — | $15 | 0.11% |
| LAVADA LYNN SCARLETT Filed as: LAVADA L SCARLETT | 3619 SHADY OAK TRAIL GAINESVILLE, GA 30506 | CONTINENTAL AMERICAN INSURANCE COMPANY | $13 | — | $13 | 0.10% |
| DAYTON LLC | 221 SERENITY DR PICKENS, SC 29671 | CONTINENTAL AMERICAN INSURANCE COMPANY | $9 | — | $9 | 0.07% |
| GARY W JOHNSON | 201 W MCBEE AVE STE 301 GREENVILLE, SC 29601 | CONTINENTAL AMERICAN INSURANCE COMPANY | $9 | — | $9 | 0.07% |
| RICHARD SMITHSON | 2000 BROOKE FOREST CT ALPHARETTA, GA 30022 | CONTINENTAL AMERICAN INSURANCE COMPANY | $9 | — | $9 | 0.07% |
| JAMES D DUDLEY | 3061 EDGEWOOD CT COLUMBUS, GA 31907 | CONTINENTAL AMERICAN INSURANCE COMPANY | $7 | — | $7 | 0.05% |
| KATHLEEN T BENES | 249 WEATHER STONE POINTE DR WOODSTOCK, GA 30188 | CONTINENTAL AMERICAN INSURANCE COMPANY | $7 | — | $7 | 0.05% |
| JOHN P KOWN II | 1275 SHILOH ROAD NW KENNESAW, GA 30144 | CONTINENTAL AMERICAN INSURANCE COMPANY | $4 | — | $4 | 0.03% |
| MARIA RADCLIFFE Filed as: MARIA K RADCLIFFE | 1105 BRIDLE PATH DR LAWRENCEVILLE, GA 30045 | CONTINENTAL AMERICAN INSURANCE COMPANY | $4 | — | $4 | 0.03% |
| STEVEN VORDERLANDWEHR | 2219 MCCAHILL CT BUFORD, GA 30519 | CONTINENTAL AMERICAN INSURANCE COMPANY | $4 | — | $4 | 0.03% |
| HELEN DIANE BORDER | PO BOX 711 WATKINSVILLE, GA 30677 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3 | — | $3 | 0.02% |
| LEE R MCGRAW | 9722 FALLVIEW CT VILLA RICA, GA 30180 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3 | — | $3 | 0.02% |
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 | 235 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 239 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA | 539 | $553K |
| Dental(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA | 539 | $2.2M |
| Vision(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA | 539 | $2.2M |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 370 | $298K |
| Short-term disability(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 370 | $325K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 370 | $298K |
| Prescription drug | CIGNA | 539 | $553K |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 370 | $325K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 539 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.