| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | 11330 LAKEFIELD DRIVE SUITE 100 JOHNS CREEK, GA 30097 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $154K | — | $154K | 10.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | 11330 LAKEFIELD DRIVE SUITE 100 JOHNS CREEK, GA 30097 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $176K | — | $176K | 15.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | 11330 LAKEFIELD DRIVE SUITE 100 JOHNS CREEK, GA 30097 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $83K | — | $83K | 10.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | 11330 LAKEFIELD DRIVE SUITE 100 JOHNS CREEK, GA 30097 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $68K | — | $68K | 15.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY LLC | P O BOX 70 WEST POINT, GA 31833 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $50K | $2K | $52K | 13.52% |
| KLD INSURANCE BENEFITS INC3 Filed as: KLD INS BENEFITS INC | 9085 BETHEL ROAD GAINESVILLE, GA 30506 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $22K | $13K | $35K | 9.06% |
| TULLY AND COMPANY INC3 Filed as: TULLY AND COMPANY | 1926 STONE BRIDGE LANE MARIETTA, GA 30064 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $9K | $791 | $10K | 2.66% |
| C ADAMS VOLK3 | 2295 OLD ORCHARD DRIVE MARIETTA, GA 30068 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $1K | $6K | 1.59% |
| AMY E COHEN3 | 19967 VILLA LANTE PLACE BOCA RATON, FL 33434 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $166 | $3K | 0.66% |
| CHARLES AUGUSTUS RAY3 | 12010 BROOKFIELD CLUB ROAD ROSWELL, GA 30075 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $589 | $2K | 0.59% |
| EMILY PORRECA3 | 146 WINDFIELDS LANE WOODSTOCK, GA 30188 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $531 | $954 | $1K | 0.38% |
| NORMAC SOLUTIONS INC3 | 451 HOPKINS ROAD TOWNVILLE, SC 29689 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $3 | $1K | 0.30% |
| PEACOCK FINANCIALS INC3 | 11830 NW 32ND MNR SUNRISE, FL 33323 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $293 | $474 | $767 | 0.20% |
| LAURIE J BURNS3 | 15 CEDARS EDGE COURT BLUFFTON, SC 29910 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $441 | — | $441 | 0.11% |
| ELIZABETH LOUISE FENDER3 | 335 S EMERSON AVENUE INDIANAPOLIS, IN 46219 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $401 | $31 | $432 | 0.11% |
| EOB CONSULTING LLC3 | 2500 NORTHWINDS PARKWAY ALPHARETTA, GA 30009 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $221 | — | $221 | 0.06% |
| CAROL PURDY FIELDS3 | 204 POTOMAC COURT WOODSTOCK, GA 30188 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $130 | — | $130 | 0.03% |
| DANA MARIE MOWATT3 | 23701 S WESTERN AVENUE UNIT 112 TORRANCE, CA 90501 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $114 | $5 | $119 | 0.03% |
| CAROLE H WARREN3 | 2716 HANOVER CIRCLE BIRMINGHAM, AL 35205 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $109 | — | $109 | 0.03% |
| MITCHELL HECTOR MORALES3 | 4679 SCORE COURT SNELLVILLE, GA 30039 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $106 | — | $106 | 0.03% |
| MARIA VERONICA JARQUE3 | 4525 GEORGIA ST SAN DIEGO, CA 92116 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $76 | $24 | $100 | 0.03% |
| NORTH FLORIDA BENEFIT SOLUTIONS INC3 | 12659-1 PLUMMER GRANT ROAD JACKSONVILLE, FL 32258 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $76 | — | $76 | 0.02% |
| BARBARA J LAKE3 | 226 N HIGH STREET MORRISTOWN, IN 46161 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $61 | — | $61 | 0.02% |
| JEFFREY LUXENBERG3 | 307 LONGTREE LANE LOGANSPORT, IN 46947 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $51 | $4 | $55 | 0.01% |
| TIMOTHY J REED3 | 21 AZALEA DRIVE LUMBERTON, NJ 08048 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $41 | — | $41 | 0.01% |
| PLM SOLUTIONS INC3 | 557 GRAVES ROAD WEDOWEE, AL 36278 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $39 | — | $39 | 0.01% |
| B V STONE INC3 Filed as: BV STONE INC | 1800 SUNSET HARBOUR POINTE LAWRENCEVILLE, GA 30043 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $22 | — | $22 | 0.01% |
| SHARON SIMPSON MCCLENDON3 | 4207 TURKEY CREEK ROAD PLANT CITY, FL 33567 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $18 | — | $18 | 0.00% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $7 | $11 | $18 | 0.00% |
| HOWARD HOROWITZ3 Filed as: HOWARD J HOROWITZ | 2610 ALCOTT STREET CARMEL, IN 46032 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $13 | — | $13 | 0.00% |
| WENDY DAWN PACK3 | 16109 WATT WAY RAMONA, CA 92065 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $10 | $3 | $13 | 0.00% |
| CLARICE R MIMS3 | 172-90 HIGHLAND AVENUE JAMAICA ESTATES, NY 11432 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $12 | — | $12 | 0.00% |
| SANDRA SIMS3 | 13750 W COLONIAL DRIVE SUITE 350 WINTER GARDEN, FL 34787 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.00% |
| DALE T BUTLER3 | 15234 REEDS STREET OVERLAND PARK, KS 66223 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.00% |
| ALLYN INCORPORATED3 | 14813 SEMINOLE TRAIL SEMINOLE, FL 33776 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.00% |
| DONNA ROSS SMITH3 | 2632 JUDES FERRY ROAD POWHATAN, VA 23139 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.00% |
| CHALSEE CANTRELL3 Filed as: CHALSEE DENE CANTRELL | 5407 COUNTY ROAD 1042 CELESTE, TX 75423 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.00% |
| YOUNG AGENCY LLC3 | 326 WESLEY CIRCLE MACON, GA 31204 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.00% |
| TODD BOOZER3 | 2900 CAHABA ROAD BIRMINGHAM, AL 35205 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4 | $1 | $5 | 0.00% |
| CHRISTENSEN GROUP INC3 | 9855 W 78TH STREET EDEN PRAIRIE, MN 55344 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.00% |
| WILLIAM RICHARD KYZER3 | 8211 GORDON LANE HERMITAGE, TN 37076 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.00% |
| ASSUREDPARTNERS3 Filed as: JENNIFER ROSE SMITH | 4920 W SAN RAFAEL ST TAMPA, FL 33629 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.00% |
| JANTELLE LAVONNE BONNER3 | 974 ROSEFIELD LANE AURORA, IL 60504 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | $2 | $3 | 0.00% |
| CYD M WYATT3 | 1011 N 49TH AVE OMAHA, NE 68132 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| ELAISIUS BONNER3 | 974 ROSEFIELD LANE AURORA, IL 60504 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | $1 | $2 | 0.00% |
| ROBERT SCOTT BRUNER3 | 24620 E CEDAR LAKE DRIVE NEW PRAGUE, MN 56071 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | $1 | $2 | 0.00% |
| JILL R LAMBERT3 | 12741 JEFFERSON ST NE BLAINE, MN 55434 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | $1 | $2 | 0.00% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | $1 | $2 | 0.00% |
| ELIZABETH MARIE LANGEVIN3 | 698 W LARPENTEUR AVE ST PAUL, MN 55113 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | $1 | $2 | 0.00% |
| BRENDA GAIL PATE3 | 12050 LAKESHORE WAY OXFORD, FL 34484 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| JEFFREY D HARNED3 Filed as: JEFFREY LYLES | 3872 BALLANTRAE ROAD EAGAN, MN 55122 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| DENNIS L HUMPHREY3 | 3114 BROOKHAVEN COURT DEER PARK, TX 77536 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| CAROLINA BENEFITS SOURCE INC3 | 4461 NE 30TH AVENUE LIGHTHOUSE PT, FL 33064 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| BENEFIT CONSULTANTS INC3 | 2105 VESTIVA LAKE DRIVE BIRMINGHAM, AL 35216 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| CHERYL DAGATA DBA CAD & JAD CONSULT4 | 130 PROMINENCE POINT PKWY SUITE 130-339 CANTON, GA 30114 | PREPAID LEGAL SERVICES INC DBA LEGAL SHIELD | $6K | — | $6K | 10.82% |
| TOM EATON4 | 2934 KELLOGG CREEK ROAD ACWORTH, GA 30102 | PREPAID LEGAL SERVICES INC DBA LEGAL SHIELD | $4K | — | $4K | 6.20% |
| RAY CLEVELAND4 | 340 GOSHAWK RIDGE SW ATLANTA, GA 30331 | PREPAID LEGAL SERVICES INC DBA LEGAL SHIELD | $30 | — | $30 | 0.05% |
| CHARLES STEELE4 | 4344 BELLWOOD CIRCLE COLLEGE PARK, GA 30349 | PREPAID LEGAL SERVICES INC DBA LEGAL SHIELD | $29 | — | $29 | 0.05% |
| IRENE SMITH3 | 3489 W MINERAL BUTTE DR QUEEN CREEK, AZ 85142 | PREPAID LEGAL SERVICES INC DBA LEGAL SHIELD | $28 | — | $28 | 0.05% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY LLC | P O BOX 70 WEST POINT, GA 31833 | THE PAUL REVERE LIFE INSURANCE COMPANY | $366 | — | $366 | 11.42% |
| KLD INSURANCE BENEFITS INC3 | 9085 BETHEL ROAD GAINESVILLE, GA 30506 | THE PAUL REVERE LIFE INSURANCE COMPANY | $249 | $41 | $290 | 9.05% |
| AMY E COHEN3 | 19967 VILLA LANTE PLACE BOCA RATON, FL 33434 | THE PAUL REVERE LIFE INSURANCE COMPANY | $40 | $2 | $42 | 1.31% |
| C ADAMS VOLK3 | 2295 OLD ORCHARD DRIVE MARIETTA, GA 30068 | THE PAUL REVERE LIFE INSURANCE COMPANY | $40 | — | $40 | 1.25% |
| CHARLES AUGUSTUS RAY3 | 12010 BROOKFIELD CLUB ROAD ROSWELL, GA 30075 | THE PAUL REVERE LIFE INSURANCE COMPANY | $19 | — | $19 | 0.59% |
| NORMAC SOLUTIONS INC3 | 451 HOPKINS ROAD TOWNVILLE, SC 29689 | THE PAUL REVERE LIFE INSURANCE COMPANY | $13 | — | $13 | 0.41% |
| CAROLE H WARREN3 | 2716 HANOVER CIRCLE BIRMINGHAM, AL 35205 | THE PAUL REVERE LIFE INSURANCE COMPANY | $5 | — | $5 | 0.16% |
| EMILY PORRECA3 | 146 WINDFIELDS LANE WOODSTOCK, GA 30188 | THE PAUL REVERE LIFE INSURANCE COMPANY | $5 | — | $5 | 0.16% |
| LAURIE J BURNS3 | 15 CEDARS EDGE COURT BLUFFTON, SC 29910 | THE PAUL REVERE LIFE INSURANCE COMPANY | $4 | — | $4 | 0.12% |
| PEACOCK FINANCIALS INC3 | 11830 NW 32ND MNR SUNRISE, FL 33323 | THE PAUL REVERE LIFE INSURANCE COMPANY | $3 | — | $3 | 0.09% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMIN | Contract Administrator Service code 13 | — | $2.9M |
| VIRGIN PULSE INC WELLNESS PROGRAM | Other fees Service code 99 | 75 FOUNTAIN STREET SUITE 310 PROVIDENCE, RI 02902 | $452K |
| DELTA DENTAL INSURANCE COMPANY EIN 94-2761537 CLAIMS ADMIN | Contract Administrator; Plan Administrator; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $190K |
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 | 8,770 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 18 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 413 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 9,201 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL INSURANCE COMPANY | 8,732 | $0 |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 9,599 | $1.6M |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 3,571 | $832K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 3,382 | $1.5M |
| Stop-loss / reinsurancereinsurance | AETNA LIFE INSURANCE CO | 5,031 | $3.4M |
| Other(6 contracts, 5 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 12,000 | $2.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 12,000 | — |
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.