| 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. | $87K | $2K | $89K | 7.37% |
| USI INSURANCE SERVICES LLC3 | 2502 NORTH ROCKY POINT DRIVE TAMPA, FL 33607 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9K | $393 | $10K | 16.40% |
| JENNIFER WEYMOUTH RESMONDO3 Filed as: JENNIFER WEYMOUTH, LLC AND AGENTS | 2940 OAKTREE DRIVE KISSIMMEE, FL 34744 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $2K | $5K | 8.87% |
| SARAH WEYMOUTH3 Filed as: SARAH WEYMOUTH, LLC | 107 OCEAN TERRACE INDIALANTIC, FL 32903 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $816 | $2K | 3.87% |
| DW YOUNG AGENCY INC3 Filed as: DW YOUNG AGENCY, INC. | 347 CHURCH ROAD STOCKBRIDGE, GA 30281 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $112 | $2K | 3.79% |
| KEISHA RAVENELL3 | 1796 SATELLITE BOULEVARD UNIT 1317 DULUTH, GA 30097 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $288 | $2K | 3.58% |
| WORKSITE BENEFITS SOLUTION LLC3 Filed as: WORKSITE BENEFITS SOLUTION, LLC | 2622 WYMAN CIRCLE KISSIMMEE, FL 34744 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $818 | $2K | 3.35% |
| CALVON Y BUCZKOWSKI3 Filed as: CALVON Y. BUCZKOWSKI | 204 COVERED BRIDGE DRIVE OCOEE, FL 34761 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $734 | $438 | $1K | 1.99% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | GREATER GEORGIA LIFE | $2K | $1K | $4K | 16.04% |
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 | 168 | 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) | 168 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | 198 | $1.2M |
| Dental | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | 198 | $1.2M |
| Vision | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | 198 | $1.2M |
| Life insurance | GREATER GEORGIA LIFE | 168 | $23K |
| Prescription drug | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | 198 | $1.2M |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 168 | $82K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 198 | — |
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.