| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 3475 PIEDMONT ROAD NE, SUITE 800 ATLANTA, GA 30305 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $103K | $31K | $134K | 19.53% |
| KIMBERLY M. CORNELL3 | 3138 ELLEN COURT SE COVINGTON, GA 30014 | AFLAC | $19K | $657 | $20K | 9.31% |
| JENNIFER T CARMAN3 Filed as: JENNIFER T. CARMAN AND OTHER AGENTS | 1919 NOBLIN WOOD TRAIL DULUTH, GA 30097 | AFLAC | $4K | $33 | $4K | 1.74% |
| JAMES DAVIS3 Filed as: JAMES E. DAVIS | 1506 KLONDIKE ROAD SW, SUITE 100 CONYERS, GA 30094 | AFLAC | $3K | $138 | $3K | 1.55% |
| ROBERT SPENCE YARBROUGH3 | 2764 NORTH THOMPSON ROAD NE BROOKHAVEN, GA 30319 | AFLAC | $2K | $0 | $2K | 1.13% |
| WILLIAM M WARDLAW JR3 Filed as: WILLIAM M. WARDLAW JR. | 5300 OAKBROOK PARKWAY, SUITE 300 NORCROSS, GA 30093 | AFLAC | $2K | $134 | $2K | 1.01% |
| TONYA S LANCASTER3 Filed as: TONYA S. LANCASTER | 1820 THE EXCHANGE SE, SUITE 750 ATLANTA, GA 30339 | AFLAC | $2K | $0 | $2K | 0.82% |
| JONATHAN ALI HAJIMOMEN3 Filed as: JONATHAN W. LUCAS | 6250 BROWNS BRIDGE ROAD CUMMINGS, GA 30041 | AFLAC | $2K | $0 | $2K | 0.76% |
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 | 1,241 | 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) | 1,241 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL INSURANCE COMPANY | 2,278 | $804K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 2,328 | $86K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,241 | $686K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,241 | $686K |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,241 | $900K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,328 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.