| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 3475 PIEDMONT ROAD, SUITE 800 ATLANTA, GA 30305 | KAISER FOUNDATION HEALTH PLAN OF GEORGIA | $56K | $0 | $56K | 4.90% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | PO BOX 201503 DALLAS, TX 75320 | UNION SECURITY INSURANCE COMPANY | $4K | $0 | $4K | 5.00% |
| PEARLEAN WASHINGTON3 | 2518 DULUTH HIGHWAY 120, SUITE 202 DULUTH, GA 30097 | AFLAC | $7K | $29 | $7K | 7.94% |
| GEORGE LEE WASHINGTON3 | 2518 DULUTH HIGHWAY 120, SUITE202 DULUTH, GA 30097 | AFLAC | $6K | $877 | $7K | 7.51% |
| JAMES DAVIS3 Filed as: JAMES E. DAVIS | 1506 KLONKDIKE ROAD SW, SUITE 100 CONYERS, GA 30094 | AFLAC | $2K | $89 | $2K | 2.71% |
| WILLIAM M WARDLAW JR3 Filed as: WILLIAM M. WARDLAW, JR. | 5300 OAKBROOK PARKWAY, SUITE 300 NORCROSS, GA 30093 | AFLAC | $2K | $220 | $2K | 2.20% |
| MARIAN HORNE3 Filed as: MARIAN HORNE AND OTHER AGENTS | 2008 SUMMERWALK PARKWAY TUCKER, GA 30084 | AFLAC | $1K | $22 | $1K | 1.63% |
| TONYA V MEYER3 Filed as: TONYA V. MEYER | 4705 GULFORD FOREST DRIVE SW ATLANTA, GA 30331 | AFLAC | $1K | $185 | $1K | 1.52% |
| MRS JACKSON BOYUM3 Filed as: MRS. JACKSON BOYUM | 2040 SKYLAR LEIGH DRIVE BUFORD, GA 30518 | AFLAC | $313 | $0 | $313 | 0.36% |
| USI INSURANCE SERVICES LLC3 | 3475 PIEDMONT ROAD, SUITE 800 ATLANTA, GA 30305 | SUN LIFE ASSURANCE COMPANY OF CANADA | $3K | $0 | $3K | 10.00% |
| USI INSURANCE SERVICES LLC3 | 580 NORTH 4TH STREET, SUITE 400 COLUMBUS, OH 43215 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | $1K | $5K | 17.52% |
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 | 0 | 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) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF GEORGIA | 233 | $1.2M |
| Dental | UNION SECURITY INSURANCE COMPANY | 139 | $89K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 155 | $32K |
| Short-term disability | AFLAC | 94 | $87K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 75 | $29K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN OF GEORGIA | 233 | $1.2M |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 155 | $32K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 233 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.