| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NATIONAL HEALTH INSURANCE COMPANY3 | PO BOX 619999 DALLAS, TX 75261 | NATIONAL HEALTH INSURANCE COMPANY | — | $161K | $161K | 16.49% |
| NATIONAL GENERAL INSURANCE COMPANY3 | 1515 NORTH RIVERCENTER DR, STE 135 MILWAUKEE, WI 53212 | NATIONAL HEALTH INSURANCE COMPANY | — | $144K | $144K | 14.73% |
| JAMES R CARTER3 | 5031 MAPLES FERRY WAY EVANS, GA 30809 | NATIONAL HEALTH INSURANCE COMPANY | — | $50K | $50K | 5.11% |
| BROKERS HOLDING GROUP3 | 455 ST. ANDREWS RD SUITE E-1 COLUMBIA, SC 29210 | NATIONAL HEALTH INSURANCE COMPANY | — | $33K | $33K | 3.35% |
| KELLY E FOX3 | PO BOX 2976 GAINESVILLE, GA 30503 | NATIONAL HEALTH INSURANCE COMPANY | — | $12K | $12K | 1.28% |
| LEGACY RISK SOLUTIONS LLC3 | 3633 WHEELER RD STE 203 AUGUSTA, GA 30909 | GUARDIAN | $10K | — | $10K | 9.01% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS AND FINANCIAL | 12404 PARK CENTRAL DRIVE ST 400S DALLAS, TX 75251 | GUARDIAN | $5K | — | $5K | 4.80% |
| JAMES R CARTER3 | 5031 MAPLES FERRY WAY EVANS, GA 30809 | GUARDIAN | $832 | — | $832 | 0.77% |
| KERRY C EZZELL3 | PO BOX 15074 AUGUSTA, GA 30919 | HARTFORD LIFE AND ACCIDENT | $3K | $266 | $3K | 4.84% |
| JAMES R CARTER3 | 5031 MAPLES FERRY WAY EVANS, GA 308095705 | HARTFORD LIFE AND ACCIDENT | $3K | — | $3K | 4.42% |
| VBW INSURANCE SERVICES, INC.3 | 1090 HERSHEY DRIVE MARIETTA, GA 30062 | HARTFORD LIFE AND ACCIDENT | $81 | $2K | $2K | 4.21% |
| TRAVERS W PAINE3 | 209 DIXON CT EVANS, GA 30809 | HARTFORD LIFE AND ACCIDENT | $2K | — | $2K | 3.06% |
| AUBREY W WILLIAMS3 | 3228 WINDING WOOD PLACE AUGUSTA, GA 30907 | HARTFORD LIFE AND ACCIDENT | $854 | — | $854 | 1.48% |
| LEGACY RISK SOLUTIONS LLC3 | PO BOX 2976 GAINESVILLE, GA 30503 | HARTFORD LIFE AND ACCIDENT | $838 | — | $838 | 1.45% |
| LEGACY RISK SOLUTIONS LLC3 | 434 GREEN ST NE GAINESVILLE, GA 30501 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $926 | $3K | 7.59% |
| JAMES R CARTER3 | 5031 MAPLES FERRY WAY EVANS, GA 30809 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 5.00% |
| KERRY C EZZELL3 | PO BOX 15074 AUGUSTA, GA 30919 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 5.00% |
| TRAVERS W PAINE3 | 209 DIXON CT EVANS, GA 30809 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 5.00% |
| LEGACY RISK SOLUTIONS LLC3 | 434 GREEN ST NE GAINESVILLE, GA 30501 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $866 | $3K | 8.95% |
| JAMES R CARTER3 | 5031 MAPLES FERRY WAY EVANS, GA 30809 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 6.25% |
| KERRY C EZZELL3 | PO BOX 15074 AUGUSTA, GA 30919 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 6.25% |
| TRAVERS W PAINE3 | 209 DIXON CT EVANS, GA 30809 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 6.25% |
| LEGACY RISK SOLUTIONS LLC3 | 434 GREEN ST NE GAINESVILLE, GA 30501 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $669 | $2K | 7.61% |
| JAMES R CARTER3 | 5031 MAPLES FERRY WAY EVANS, GA 30809 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 5.00% |
| KERRY C EZZELL3 | PO BOX 15074 AUGUSTA, GA 30919 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 5.00% |
| TRAVERS W PAINE3 | 209 DIXON CT EVANS, GA 30809 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 5.00% |
| LEGACY RISK SOLUTIONS LLC3 | 434 GREEN ST NE GAINESVILLE, GA 30501 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $674 | $372 | $1K | 7.76% |
| JAMES R CARTER3 | 5031 MAPLES FERRY WAY EVANS, GA 30809 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $674 | — | $674 | 5.00% |
| KERRY C EZZELL3 | PO BOX 15074 AUGUSTA, GA 30919 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $674 | — | $674 | 5.00% |
| TRAVERS W PAINE3 | 209 DIXON CT EVANS, GA 30809 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $674 | — | $674 | 5.00% |
| LEGACY RISK SOLUTIONS LLC3 | 434 GREEN ST NE GAINESVILLE, GA 30501 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $260 | $126 | $386 | 7.44% |
| JAMES R CARTER3 | 5031 MAPLES FERRY WAY EVANS, GA 30809 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $260 | — | $260 | 5.01% |
| KERRY C EZZELL3 | PO BOX 15074 AUGUSTA, GA 30919 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $260 | — | $260 | 5.01% |
| TRAVERS W PAINE3 | 209 DIXON CT EVANS, GA 30809 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $260 | — | $260 | 5.01% |
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 | 197 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 197 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | NATIONAL HEALTH INSURANCE COMPANY | 131 | $978K |
| Dental | GUARDIAN | 160 | $109K |
| Vision | GUARDIAN | 160 | $109K |
| Life insurance(3 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 197 | $95K |
| Short-term disability(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 195 | $83K |
| Long-term disability(3 contracts, 3 carriers) | GUARDIAN | 195 | $202K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 197 | — |
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.