| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RELATION INSURANCE INC3 | 5825 NEDLOCK BRIDGE PARKWAY ALPHARETTA, GA 30022 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $10K | $0 | $10K | 9.85% |
| RELATION INSURANCE INC3 | 5871 GLENRIDGE ROAD ATLANTA, GA 30328 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9K | $0 | $9K | 9.43% |
| KLD INSURANCE BENEFITS INC3 Filed as: KLD INSURANCE BENEFITS | 9085 BETHEL ROAD GAINESVILLE, GA 30506 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $3K | $4K | 4.17% |
| SHERI L MITCHELL INC3 | 540 BIRNAMWOOD DRIVE SUWANEE, GA 30024 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $0 | $3K | 3.29% |
| C ADAMS VOLK3 | 2295 OLD ORCHARD DRIVE MARIETTA, GA 30068 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $411 | $2K | 2.16% |
| KLD INSURANCE BENEFITS INC3 | 9085 BETHEL ROAD GAINESVILLE, GA 30506 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $177 | $1K | 1.56% |
| EOB CONSULTING LLC3 | 2500 NORTHWINDS PARKWAY ALPHARETTA, GA 30009 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $595 | $458 | $1K | 1.10% |
| SANDRA SIMS3 | 13750 W COLONIAL DRIVE SUITE 350 WINTER GRADEN, FL 34787 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $484 | $57 | $541 | 0.56% |
| BARBARA J LAKE3 | 226 N HIGH STREET MORRISTOWN, UT 46161 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $479 | $34 | $513 | 0.53% |
| B V STONE INC3 | 1800 SUNSET HARBOUR POINTE LAWRENCEVILLE, GA 30043 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $410 | $14 | $424 | 0.44% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: NORTHWESTERN BENEFIT CORP OF GA | 3438 PEACHTREE ROAD NE ATLANTA, GA 30326 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $346 | $0 | $346 | 0.36% |
| CAROLE H WARREN3 | 1300 27TH PLACE S BIRMINGHAM, AL 35205 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $206 | $32 | $238 | 0.25% |
| NORTH FLORIDA BROKER SOLUTIONS LLC3 | 25659 1 PLUMMER GRANT JACKSONVILLE, FL 32258 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $179 | $17 | $196 | 0.20% |
| CHRISTIAN ANTHONY MALDONADO3 | 1745 HUNTINGTON HILL TRACE NE BUFORD, GA 30519 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $150 | $2 | $152 | 0.16% |
| SABRINA S RAMOS3 | 13750 W COLONIAL DRIVE WINTER GARDEN, FL 34787 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $104 | $18 | $122 | 0.13% |
| DANIEL HALL3 | PO BOX 567081 ATLANTA, GA 31156 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $103 | $0 | $103 | 0.11% |
| CD FRAZIER ASSOCIATES INC3 | 8631 STONEFACE ROAD CHARLOTTE, NC 28214 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $85 | $8 | $93 | 0.10% |
| NORMAC SOLUTIONS INC3 | 3730 EVEREST DRIVE MONTGOMERY, AL 36106 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $61 | $3 | $64 | 0.07% |
| PLM SOLUTIONS INC3 | 557 GRAVES ROAD WEDOWEE, AL 36278 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $44 | $0 | $44 | 0.05% |
| KENNETH B TORBETT3 | 453 BRUSHSTROKE COURT MARIETTA, GA 30067 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $42 | $0 | $42 | 0.04% |
| JOE GORDON3 | 5417 WINTHROP AVE INDIANAPOLIS, IN 46220 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20 | $15 | $35 | 0.04% |
| WILLIAM RENNARD3 | 3001 ALOMA AVE WINTER PARK, FL 32792 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $25 | $5 | $30 | 0.03% |
| AMY E COHEN3 | 19967 VILLA LANTE PLACE BOCA RATON, FL 33434 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $26 | $2 | $28 | 0.03% |
| NORWOOD BENEFIT SERVICES INC3 | 6478 LONG BREEZE ROAD ORLANDO, FL 32810 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $25 | $2 | $27 | 0.03% |
| ASSUREDPARTNERS3 Filed as: JENNIFER ROSE SMITH | 4920 W SAN RAFAEL STREET TAMPA, FL 33629 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $25 | $0 | $25 | 0.03% |
| JEFFREY D BRINDLE3 | 10811 LAKEVIEW DRIVE CARMEL, IN 46033 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20 | $1 | $21 | 0.02% |
| COLONIAL LIFE BROKERAGE LLC3 | 1995 TROTTERS RIDGE WAY ROSWELL, GA 30075 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | $12 | $20 | 0.02% |
| LAURA B WETT3 | 8496 100TH STREET E COTTAGE GROVE, MN 55016 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | $0 | $14 | 0.01% |
| CAROL PURDY FIELDS3 | 204 POTOMAC COURT WOODSTOCK, GA 30188 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | $0 | $14 | 0.01% |
| TULLY AND COMPANY INC3 | 1926 STONE BRIDGE LANE MARIETTA, GA 30064 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | $1 | $10 | 0.01% |
| LAURIE J BURNS3 | 303 PYLER ROAD INDIAN TRAIL, NC 28079 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | $0 | $9 | 0.01% |
| DAVID MASON DOKELL3 | 127 GREAT POINT DRIVE MOORESVILLE, NC 28117 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $0 | $4 | 0.00% |
| KYLE RUSSEY3 | 6921 E WEDGEWOOD AVE DAVIE, FL 33331 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $1 | $3 | 0.00% |
| BROCKSTAR LLC3 | 2561 FALCON RIDGE DRIVE GRAYSON, GA 30017 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | $0 | $3 | 0.00% |
| MARYLINE Z ORELLANA3 | 2949 CLIPPER COVE LANE KISSIMEE, FL 34741 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $0 | $2 | 0.00% |
| CAROL BARNES3 | 2561 FALCON RIDGE DRIVE GRAYSON, GA 30017 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
| MICHAEL A DUARTE3 | 515 DULL STREET DICKSON, TN 37055 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CREATIVE RISK UNDERWRITERS LLC EIN 47-4671512 STOP LOSS TPA | Claims processing Service code 12 | — | $181K |
| RELATION INSURANCE EIN 26-0291031 BROKER | Insurance agents and brokers Service code 22 | — | $70K |
| SISCO EIN 42-1144827 TPA | Claims processing Service code 12 | — | $59K |
| CIGNA EIN 59-1031071 NETWORK | Claims processing Service code 12 | — | $28K |
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 | 190 | 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) | 190 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 190 | $104K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 190 | $104K |
| Other | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 123 | $96K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 190 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.