| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PATRIOT GROWTH INSURANCE SERVICES3 | 400 INTERSTATE NORTH PKWY SE STE 300 ATLANTA, GA 30339 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $5K | $0 | $5K | 1.35% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 501 OFFICE CENTER DR STE 215 FORT WASHINGTON, PA 19034 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $21K | $0 | $21K | 10.52% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 6000 FELDWOOD RD LOCKBOX 741738 COLLEGE PARK, GA 30349 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $3K | $3K | 1.38% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 501 OFFICE CENTER DR STE 215 FORT WASHINGTON, PA 19034 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $17K | $0 | $17K | 10.69% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 6000 FELDWOOD RD LOCKBOX 741738 COLLEGE PARK, GA 30349 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $2K | $2K | 1.15% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 501 OFFICE CENTER DR STE 215 FORT WASHINGTON, PA 19034 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $0 | $3K | 10.61% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 6000 FELDWOOD RD LOCKBOX 741738 COLLEGE PARK, GA 30349 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $152 | $152 | 0.48% |
| J KEEBS & ASSOCIATES3 Filed as: J KEEBS & ASSOCIATES LLC | 1810 BLOSSOM CREEK LN CUMMING, GA 30040 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $1K | $3K | 33.45% |
| ERIS VENTURES LLC3 | 931 MONROE DRIVE ATLANTA, GA 30308 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $846 | $3K | 25.02% |
| MITCHELL HECTOR MORALES3 | 1264 GABLES VIEW PL LAWRENCEVILLE, GA 30043 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $521 | $58 | $579 | 5.66% |
| WILLIAM RICHARD KYZER3 | 8211 GORDON LN HERMITAGE, TN 37076 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $316 | $143 | $459 | 4.49% |
| TODD CLARK LEE3 | 1443 LADY SLIPPER CT NW KENNESAW, GA 30152 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $347 | $1 | $348 | 3.40% |
| DEBORAH J BELLINO3 | 2012 LADY LAKE ST LAS VEGAS, NV 89128 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $227 | $12 | $239 | 2.34% |
| CLARICE D LEWIS LLC3 | 8631 STONEFACE RD CHARLOTTE, NC 28214 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $139 | $13 | $152 | 1.49% |
| BENEFOUNDRY INC3 | 3013 LARGE HOP LN ANTIOCH, TN 37013 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $46 | $38 | $84 | 0.82% |
| BENEFITTING YOU INC3 | 2497 CITRUS GARDEN CIR HENDERSON, NV 89052 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $34 | $16 | $50 | 0.49% |
| ZORAIDA VELEZ3 | 30205 GOODWICK WAY WESLEY CHAPEL, FL 33543 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $30 | $4 | $34 | 0.33% |
| DAVID MASON DOKELL3 | 159 BEACON DR UNIT A MOORESVILLE, NC 28117 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20 | $1 | $21 | 0.21% |
| WORKSITE AMERICA LLC3 | 14141 46TH ST N STE 1209 CLEARWATER, FL 33762 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $2 | $4 | 0.04% |
| SHIRR3 | 14141 46TH ST N STE 1209 CLEARWATER, FL 33762 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $0 | $2 | 0.02% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 501 OFFICE CENTER DR STE 215 FORT WASHINGTON, PA 19034 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | $456 | $0 | $456 | 9.99% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 6000 FELDWOOD RD LOCKBOX 741738 COLLEGE PARK, GA 30349 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | $0 | $35 | $35 | 0.77% |
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 | 462 | 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) | 466 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 380 | $333K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 380 | $333K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 631 | $157K |
| Short-term disability | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | 557 | $5K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 586 | $202K |
| Other(3 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 631 | $200K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 631 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.