| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SERVICES USA INC | 3475 PIEDMONT ROAD SUITE 800 ATLANTA, GA 30305 | KAISER FOUNDATION HEALTH PLAN OF GEORGIA | $54K | $0 | $54K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SERVICES USA INC | PO BOX 201503 DALLAS, TX 75320 | UNION SECURITY INSURANCE COMPANY | $5K | $0 | $5K | 5.00% |
| GEORGE LEE WASHINGTON3 | 2518 DULUTH HIGHWAY 120 STE 202 DULUTH, GA 30097 | AFLAC | $9K | $266 | $10K | 11.25% |
| PEARLEAN WASHINGTON3 | 2518 DULUTH HIGHWAY 120 STE 202 DULUTH, GA 30097 | AFLAC | $3K | $93 | $3K | 3.41% |
| WILLIAM M WARDLAW JR3 | 5300 OAKBROOK PKWY STE 300 NORCROSS, GA 30093 | AFLAC | $2K | $91 | $2K | 2.08% |
| TONYA V MEYER3 | 4705 GUILFORD FOREST DR SW ATLANTA, GA 30331 | AFLAC | $2K | $0 | $2K | 1.95% |
| JAMES DAVIS3 Filed as: JAMES E DAVIS | 1506 KLONKIKE RD SW STE 100 CONYERS, GA 30094 | AFLAC | $563 | $0 | $563 | 0.66% |
| MRS JACKSON BOYUM3 | 2040 SKYLAR LEIGH DR BUFORD, GA 30518 | AFLAC | $397 | $0 | $397 | 0.47% |
| MARIAN HORNE3 | PO BOX 1607 SNELLVILLE, GA 30078 | AFLAC | $396 | $0 | $396 | 0.47% |
| RONALD E KIRKLAND3 | 1044 HARBOR RIDGE RD GUNTERSVILLE, AL 35976 | AFLAC | $254 | $0 | $254 | 0.30% |
| JAMAAL RICHARD3 | 2591 PIEDMONT RD NE APT 1131 ATLANTA, GA 30324 | AFLAC | $131 | $0 | $131 | 0.15% |
| SCOTT A SMITH3 | 5300 OAKBROOK PKWY STE 300 STE 350 NORCROSS, GA 30093 | AFLAC | $87 | $0 | $87 | 0.10% |
| LARRY W FLOWERS3 | 2318 PROVINCIAL POINT DR GAINESVILLE, GA 30501 | AFLAC | $80 | $0 | $80 | 0.09% |
| THOMAS ROBERT GIDDENS3 | PO BOX 2517 KENNESAW, GA 30156 | AFLAC | $75 | $0 | $75 | 0.09% |
| IVAN S WASHINGTON3 | PO BOX 2134 STONE MOUNTAIN, GA 30086 | AFLAC | $61 | $0 | $61 | 0.07% |
| JUDIETTE RODGERS3 | 2140 EDGEMORE DR SE ATLANTA, GA 30316 | AFLAC | $58 | $0 | $58 | 0.07% |
| ROBYN M ROBERTS3 | 3340 PEYTON DR MONROE, GA 30656 | AFLAC | $47 | $0 | $47 | 0.06% |
| ANN BLAKE BOSWELL3 | 910 WOLF SPRINGS CV LAWRENCEVILLE, GA 30043 | AFLAC | $40 | $0 | $40 | 0.05% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: ROGER W BROWN | 1575 RIDENOUR PKWY NW APT 1534 KENNESAW, GA 30152 | AFLAC | $37 | $0 | $37 | 0.04% |
| PAT STALLARD INC3 | 6738 HOLIDAY PT BUFORD, GA 30518 | AFLAC | $31 | $0 | $31 | 0.04% |
| STEVEN VORDERLANDWEHR3 | 1599 AMHEARST MILL DR LAWRENCEVILLE, GA 30043 | AFLAC | $25 | $0 | $25 | 0.03% |
| LONNIE R VOGLER3 | 5388 E MOUNTAIN ST STONE MOUNTAIN, GA 30083 | AFLAC | $23 | $0 | $23 | 0.03% |
| ANSON S RAMSEY3 | 540 POWDER SPRINGS ST STE B7 MARIETTA, GA 30064 | AFLAC | $22 | $0 | $22 | 0.03% |
| JUDIETTE RODGERS3 | 205 BUTTERFIELD LN FAYETTEVILLE, GA 30214 | AFLAC | $22 | $0 | $22 | 0.03% |
| VANCE C SMITH III3 | 5300 OAKBROOK PKWY BLGD 300 STE 350 NORCROSS, GA 30093 | AFLAC | $22 | $0 | $22 | 0.03% |
| RAYMOND L MELVIN3 | 1553 NAVIGATOR CIR DACULA, GA 30019 | AFLAC | $22 | $0 | $22 | 0.03% |
| JAMES D DUDLEY3 | 1355 LYNNFIELD RD STE 259 MEMPHIS, TN 38119 | AFLAC | $19 | $0 | $19 | 0.02% |
| MULTIPLE BENEFITS CORPORATION3 | PO BOX 1205 LAWRENCEVILLE, GA 30046 | AFLAC | $17 | $0 | $17 | 0.02% |
| DORIS L BRACKETT3 | 3233 HIGHGATE CHASE CT BERKELEY LAKE, GA 30092 | AFLAC | $16 | $0 | $16 | 0.02% |
| TONYA S LANCASTER3 | 1820 THE EXCHANGE SE STE 750 ATLANTA, GA 30339 | AFLAC | $15 | $0 | $15 | 0.02% |
| DEBORAH B SMITH3 | 5703 BRYNWOOD CIR NW ACWORTH, GA 30101 | AFLAC | $14 | $0 | $14 | 0.02% |
| JOHN DALLAS BYERS3 | 2026 VALLEY BROOK DR BRENTWOOD, TN 37027 | AFLAC | $13 | $0 | $13 | 0.02% |
| LEE RYAN MCGRAW3 | 1170 MANN RD DOUGLASVILLE, GA 30134 | AFLAC | $11 | $0 | $11 | 0.01% |
| PAUL SHELBY AMOS II3 | 1932 WYNNTON RD 14TH FLOOR COLUMBUS, GA 31999 | AFLAC | $10 | $0 | $10 | 0.01% |
| DUSTIN ROBERT JOHNSON3 | 50 HURT PLZ SE STE 995 ATLANTA, GA 30303 | AFLAC | $10 | $0 | $10 | 0.01% |
| KATHERINE LATIMER3 | 90 CECILY CT FORTSON, GA 31808 | AFLAC | $9 | $0 | $9 | 0.01% |
| R STEVEN BURROUGHS3 | 2164 WHITEHALL DR NE MARIETTA, GA 30066 | AFLAC | $7 | $0 | $7 | 0.01% |
| JENNIFER T CARMAN3 | 1919 NOBLIN WOODS TRL DULUTH, GA 30097 | AFLAC | $7 | $0 | $7 | 0.01% |
| SUSAN REDDOCH BUFFINGTON3 | 400 TAX RD SHILOH, GA 31826 | AFLAC | $7 | $0 | $7 | 0.01% |
| DAVID C CLOUD JR3 | 12 TRENT DR SE ROME, GA 30161 | AFLAC | $6 | $0 | $6 | 0.01% |
| JONATHAN D PINCUS3 | 432 CAMPBELL HILL ST NW MARIETTA, GA 30060 | AFLAC | $6 | $0 | $6 | 0.01% |
| LANCE OSBORNE3 | 21822 SEACREST LN HUNTINGTN BCH, CA 92646 | AFLAC | $6 | $0 | $6 | 0.01% |
| DEBORAH B SMITH3 | 2522 OWENS LANDING TRL NW KENNESAW, GA 30152 | AFLAC | $5 | $0 | $5 | 0.01% |
| STEVEN VORDERLANDWEHR3 | 1242 HADAWAY TRL LAWRENCEVILLE, GA 30043 | AFLAC | $5 | $0 | $5 | 0.01% |
| SCOTTI MADISON3 | 3330 COBB PARKWAY SUITE 324-3 ACWORTH, GA 30101 | AFLAC | $5 | $0 | $5 | 0.01% |
| DEBORAH B SMITH3 | 4720 TWIN OAKS DR NW KENNESAW, GA 30152 | AFLAC | $5 | $0 | $5 | 0.01% |
| CHRISTIE MARZARI3 Filed as: CHRISTIE M MARZARI | 1932 WYNNTON RD COLUMBUS, GA 31999 | AFLAC | $4 | $0 | $4 | 0.00% |
| TARRAH SMITHSON3 Filed as: TARRAH L SMITHSON | 449 TIMBER PL MILTON, GA 30004 | AFLAC | $4 | $0 | $4 | 0.00% |
| MARK S LEE3 | 1192 PEYTON DR NW KENNESAW, GA 30152 | AFLAC | $3 | $0 | $3 | 0.00% |
| ELENI A NIKOLAS3 | 50 HURT PLZ SE STE 1630 THE HURT BUILDING ATLANTA, GA 30303 | AFLAC | $3 | $0 | $3 | 0.00% |
| ELENI A NIKOLAS3 Filed as: ELENI A KRAUSE | 50 HURT PLZ SE STE 995 THE HURT BUILDING ATLANTA, GA 30303 | AFLAC | $3 | $0 | $3 | 0.00% |
| JOHN DALLAS BYERS3 | 2477 TITANS LN BRENTWOOD, TN 37027 | AFLAC | $2 | $0 | $2 | 0.00% |
| ANA MARIE GARCIA SMITH3 | 110 BANDERVIEW ROAD SEYMOUR, TN 37865 | AFLAC | $1 | $0 | $1 | 0.00% |
| ALLISON FARRIS WENDELBERGER3 | 207 SANTA FE DR WALNUT CREEK, CA 94598 | AFLAC | $1 | $0 | $1 | 0.00% |
| ESMERALDA M LUCAS0 | 2135 GLENFIELD TRCE CUMMING, GA 30041 | AFLAC | $1 | $0 | $1 | 0.00% |
| WENDY M RANKIN3 | 114 BROAD ST STE 201 ROME, GA 30161 | AFLAC | $1 | $0 | $1 | 0.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 3475 PIEDMONT RD NE ATLANTA, GA 30305 | SUN LIFE ASSURANCE COMPANY OF CANADA | $3K | $0 | $3K | 10.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONA | 580 N. 4TH STREET SUITE 400 COLUMBUS, OH 43215 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 13.58% |
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 | 202 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 204 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNION SECURITY INSURANCE COMPANY | 130 | $91K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 144 | $28K |
| Short-term disability | AFLAC | 82 | $85K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 71 | $24K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 144 | $28K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 202 | — |
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.