| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | $72K | $0 | $72K | 6.41% |
| USI INSURANCE SERVICES LLC3 | 2502 NORTH ROCKY POINT DRIVE TAMPA, FL 33607 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10K | $45 | $10K | 28.17% |
| SARAH WEYMOUTH3 Filed as: SARAH WEYMOUTH AND OTHER AGENTS | 107 OCEAN TERRACE INDIALANTIC, FL 32903 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $2K | $6K | 18.20% |
| DW YOUNG AGENCY INC3 Filed as: DW YOUNG AGENCY, INC. | 347 CHURCH ROAD STOCKBRIDGE, GA 30281 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $72 | $3K | 9.07% |
| KEISHA RAVENELL3 | 1796 SATELLITE BOULEVARD DULUTH, GA 30097 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $106 | $2K | 5.65% |
| WORKSITE BENEFITS SOLUTION LLC3 Filed as: WORKSITE BENEFITS SOLUTION, LLC | 2622 WYMAN CIRCLE KISSIMMEE, FL 34744 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $843 | $646 | $1K | 4.18% |
| CALVON Y BUCZKOWSKI3 Filed as: CALVON Y. BUCZKOWSKI | 2608 TALL MAPLE LOOP OCOEE, FL 34761 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $711 | $775 | $1K | 4.17% |
| MICHAEL G BOYCE3 Filed as: MICHAEL G. BOYCE | 2622 WYMAN CIRCLE KISSIMMEE, FL 34744 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $486 | $743 | $1K | 3.45% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | GREATER GEORGIA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 9.12% |
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 | 212 | 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) | 212 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | 191 | $1.1M |
| Dental | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | 191 | $1.1M |
| Vision | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | 191 | $1.1M |
| Life insurance | GREATER GEORGIA LIFE INSURANCE COMPANY | 172 | $24K |
| Prescription drug | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | 191 | $1.1M |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 172 | $59K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 191 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.