| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PATRIOT GROWTH INSURANCE SERVICES3 | 400 INTERSTATE NORTH PKWY SE STE 60 ATLANTA, GA 30339 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $15K | $4K | $19K | 14.75% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | 501 OFFICE CENTER DR STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $2K | $2K | 1.77% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 2859 PACES FERRY RD ATLANTA, GA 30339 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $275 | $2K | 12.35% |
| KLD INSURANCE BENEFITS INC3 Filed as: KLD INS BENEFITS INC | 9085 BETHEL RD GAINESVILLE, GA 30506 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $793 | $37 | $830 | 5.77% |
| DANA MARIE MOWATT3 | 23701 S WESTERN AVE SPC 112 TORRANCE, CA 90501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $610 | $145 | $755 | 5.25% |
| CHRISTY O. CHRISTIAN3 Filed as: CHRISTY O CHRISTIAN | 6235 BUCKINGHAM CIR CUMMING, GA 30040 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $163 | $0 | $163 | 1.13% |
| ANDREA MARIE TIERCE3 | 1199 MADRONE LN PLACERVILLE, CA 95667 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $71 | $34 | $105 | 0.73% |
| C MARIE ADAMS VOLK3 | 2295 OLD ORCHARD DR MARIETTA, GA 30068 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $47 | $0 | $47 | 0.33% |
| BROOKE HARMON3 Filed as: BROOKE HARMON & ASSOCIATES LLC | 70 HENRY LIVINGSTON RD POMARIA, SC 29126 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $33 | $14 | $47 | 0.33% |
| ALICE RYAN STRIBLING3 | 511 KILBOURNE RD COLUMBIA, SC 29205 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $33 | $13 | $46 | 0.32% |
| THE CLARK GROUP OF SC3 | 898 ROPER RD LAURENS, SC 29360 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | $20 | $32 | 0.22% |
| EMILY PORRECA3 | 146 WINDFIELDS LN WOODSTOCK, GA 30188 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $29 | $0 | $29 | 0.20% |
| TULLY AND COMPANY INC3 | 1926 STONE BRIDGE LN MARIETTA, GA 30064 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $27 | $0 | $27 | 0.19% |
| WILLIAM E GECEWICZ3 | 11113 LAKESIDE VISTA DR RIVERVIEW, FL 33569 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $21 | $5 | $26 | 0.18% |
| ELIZABETH LOUISE FENDER3 | 335 S EMERSON AVE INDIANAPOLIS, IN 46219 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | $0 | $14 | 0.10% |
| CINDY L WOOD3 | 5215 BLUE RIDGE OVERLOOK DAWSONVILLE, GA 30534 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | $0 | $12 | 0.08% |
| ADVANCED BENEFIT SYSTEM INC3 | 145 RIVER LANDING DR UNIT 203 DANIEL ISLAND, SC 29492 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $4 | $8 | 0.06% |
| JENNIFER E LUBELSKY3 | 80 JOHN ST APT 11C NEW YORK, NY 10038 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | $1 | $7 | 0.05% |
| CHOICE BENEFITS SOLUTIONS LLC3 | 11399 81ST PL SEMINOLE, FL 33772 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $3 | $5 | 0.03% |
| WORKSITE AMERICA LLC3 | 14141 46TH ST N STE 1209 CLEARWATER, FL 33762 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $1 | $3 | 0.02% |
| WALTER THOMAS BONILLA3 | 9 LONGLEAF LN MEDFORD, NY 11763 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.01% |
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 | 174 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 175 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 173 | $129K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 173 | $129K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 173 | $129K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 102 | $655K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 173 | $143K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 173 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.