| 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 | $156K | $29K | $184K | 11.84% |
| 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 | $163K | $27K | $190K | 17.47% |
| 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 | $80K | $24K | $104K | 12.97% |
| 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 | $71K | $20K | $91K | 19.28% |
| MARSH & MCLENNAN AGENCY LLC3 | P O BOX 70 WEST POINT, GA 31833 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $58K | $6K | $65K | 15.52% |
| KLD INSURANCE BENEFITS INC3 | 9085 BETHEL ROAD GAINESVILLE, GA 30506 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $29K | $10K | $39K | 9.32% |
| TULLY AND COMPANY INC3 | 1926 STONE BRIDGE LANE MARIETTA, GA 30064 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $11K | $635 | $12K | 2.80% |
| EMILY PORRECA3 | 146 WINDFIELDS LANE WOODSTOCK, GA 30188 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $7K | $3K | $10K | 2.46% |
| AMY E COHEN3 | 19967 VILLA LANTE PLACE BOCA RATON, FL 33434 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $223 | $2K | 0.40% |
| C ADAMS VOLK3 | 2295 OLD ORCHARD DRIVE MARIETTA, GA 30068 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 0.33% |
| ELIZABETH LOUISE FENDER3 | 335 S. EMERSON AVE INDIANAPOLIS, IN 46219 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $666 | $151 | $817 | 0.20% |
| NORMAC SOLUTIONS INC3 | 451 HOPKINS ROAD TOWNVILLE, SC 29689 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $626 | — | $626 | 0.15% |
| PEACOCK FINANCIALS INC3 | 11830 NW 32ND MANOR SUNRISE, FL 33323 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $164 | $296 | $460 | 0.11% |
| LAURIE J BURNS3 Filed as: LAURIE JANE BURNS | 1274 BICYCLE COURT YORK, SC 29745 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $323 | — | $323 | 0.08% |
| EOB CONSULTING LLC3 | 2500 NORTHWINDS PARKWAY ALPHARETTA, GA 30009 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $150 | — | $150 | 0.04% |
| JEFFREY LUXENBERG3 | 307 LONGTREE LANE LOGANSPORT, IN 46947 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $86 | $46 | $132 | 0.03% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $62 | $70 | $132 | 0.03% |
| CAROL PURDY FIELDS3 | 204 POTOMAC COURT WOODSTOCK, GA 30188 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $106 | — | $106 | 0.03% |
| MITCHELL HECTOR MORALES3 | 4679 SCORE COURT SNELLVILLE, GA 30039 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $80 | — | $80 | 0.02% |
| CAROLE H WARREN3 | 2716 HANOVER CIRCLE BIRMINGHAM, AL 35223 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $79 | $1 | $80 | 0.02% |
| DANA MARIE MOWATT3 | 23701 S WESTERN AVENUE #112 TORRANCE, CA 90501 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $66 | $3 | $69 | 0.02% |
| CHARLES AUGUSTUS RAY3 | 12010 BROOKFIELD CLUB ROAD ROSWELL, GA 30075 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $63 | — | $63 | 0.02% |
| MONICA M DEAN3 | 1855 EVERGREEN LANE ALPHARETTA, GA 30009 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $57 | — | $57 | 0.01% |
| TIMOTHY J REED3 | 21 AZALEA DRIVE LUMBERTON, NJ 08048 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $34 | — | $34 | 0.01% |
| CHRISTENSEN GROUP INC3 | 9855 W 78TH ST EDEN PRAIRIE, MN 55344 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $30 | $2 | $32 | 0.01% |
| PLM SOLUTIONS INC3 | 557 GRAVES ROAD WEDOWEE, AL 36278 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $31 | — | $31 | 0.01% |
| NORTH FLORIDA BENEFIT SOLUTIONS INC3 | 12659-1 PLUMMER GRANT ROAD JACKSONVILLE, FL 32258 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $26 | — | $26 | 0.01% |
| ROBERT SCOTT BRUNER3 | 24620 E CEDAR LAKE DRIVE NEW PRAGUE, MN 56071 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $8 | $10 | $18 | 0.00% |
| SHARON SIMPSON MCCLENDON3 | 4207 TURKEY CREEK ROAD PLANT CITY, FL 33567 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $17 | — | $17 | 0.00% |
| B V STONE INC3 Filed as: BV STONE INC | 1800 SUNSET HARBOUR POINTE LAWRENCEVILLE, GA 30043 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $15 | — | $15 | 0.00% |
| HOWARD HOROWITZ3 Filed as: HOWARD J HOROWITZ | 2610 ALCOTT STREET CARMEL, IN 46032 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $12 | — | $12 | 0.00% |
| MARIA VERONICA JARQUE3 | 2325 1/2 N ROCKWELL ST CHICAGO, IL 60647 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $9 | $2 | $11 | 0.00% |
| CLARICE R MIMS3 | 172-90 HIGHLAND AVENUE JAMAICA ESTATES, NY 11432 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $10 | — | $10 | 0.00% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5 | $3 | $8 | 0.00% |
| TODD BOOZER3 | 2900 CAHABA ROAD BIRMINGHAM, AL 35223 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5 | $1 | $6 | 0.00% |
| ELIZABETH MARIE LANGEVIN3 | 698 W LARPENTEUR AVE ST PAUL, MN 55113 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5 | $1 | $6 | 0.00% |
| JILL R LAMBERT3 | 12741 JEFFERSON STREET NE BLAINE, MN 55434 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4 | $2 | $6 | 0.00% |
| JARRET THOMAS HONAHAN3 | 3905 TAMPA ROAD OLDSMAR, FL 34677 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2 | $4 | $6 | 0.00% |
| CHALSEE CANTRELL3 Filed as: CHALSEE DENE CANTRELL | 5407 COUNTY ROAD 1042 CELESTE, TX 75423 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.00% |
| WILLIAM RICHARD KYZER3 | 8211 GORDON LANE HERMITAGE, TN 37076 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.00% |
| YOUNG AGENCY LLC3 | 326 WESLEY CIRCLE MACON, GA 31204 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.00% |
| CYD M WYATT3 | 1011 N 49TH AVE OMAHA, NE 68132 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| BRENDA GAIL PATE3 | 7803 JUNE LANE WILDWOOD, FL 34785 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| ALLYN INCORPORATED3 | 14813 SEMINOLE TRAIL SEMINOLE, FL 33776 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| DONNA ROSS SMITH3 | 2632 JUDES FERRY RD POWHATAN, VA 23139 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| JEFFREY D HARNED3 Filed as: JEFFREY LYLES | 401 E BURNSVILLE PKWY APT 320 BURNSVILLE, MN 55337 | 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% |
| WENDY DAWN PACK3 | 16109 WATT WAY RAMONA, CA 92065 | 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 | $8K | — | $8K | 10.20% |
| TOM EATON4 | 2934 KELLOGG CREEK ROAD ACWORTH, GA 30102 | PREPAID LEGAL SERVICES INC DBA LEGAL SHIELD | $4K | — | $4K | 5.52% |
| STEPHANIE N. PANCHISHIN4 Filed as: STEPHANIE PANCHISHIN | 652 ALCOVE DRIVE LITTLE ELM, TX 75068 | PREPAID LEGAL SERVICES INC DBA LEGAL SHIELD | $25 | — | $25 | 0.03% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY LLC | P O BOX 70 WEST POINT, GA 31833 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $278 | — | $278 | 4.94% |
| 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 | $510 | — | $510 | 14.67% |
| KLD INSURANCE BENEFITS INC3 | 9085 BETHEL ROAD GAINESVILLE, GA 30506 | THE PAUL REVERE LIFE INSURANCE COMPANY | $361 | $4 | $365 | 10.50% |
| EMILY PORRECA3 | 146 WINDFIELDS LANE WOODSTOCK, GA 30188 | THE PAUL REVERE LIFE INSURANCE COMPANY | $52 | — | $52 | 1.50% |
| C ADAMS VOLK3 | 2295 OLD ORCHARD DRIVE MARIETTA, GA 30068 | THE PAUL REVERE LIFE INSURANCE COMPANY | $16 | — | $16 | 0.46% |
| NORMAC SOLUTIONS INC3 | 451 HOPKINS ROAD TOWNVILLE, SC 29689 | THE PAUL REVERE LIFE INSURANCE COMPANY | $13 | — | $13 | 0.37% |
| CAROLE H WARREN3 | 2716 HANOVER CIRCLE BIRMINGHAM, AL 35205 | THE PAUL REVERE LIFE INSURANCE COMPANY | $5 | — | $5 | 0.14% |
| AMY E COHEN3 | 19967 VILLA LANTE PLACE BOCA RATON, FL 33434 | THE PAUL REVERE LIFE INSURANCE COMPANY | $4 | — | $4 | 0.12% |
| LAURIE J BURNS3 Filed as: LAURIE JANE BURNS | 1274 BICYCLE CT YORK, SC 29745 | THE PAUL REVERE LIFE INSURANCE COMPANY | $4 | — | $4 | 0.12% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA DENTAL INSURANCE COMPANY EIN 94-2761537 CLAIMS ADMIN | Contract Administrator; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Plan Administrator Service code 12 | — | $2.8M |
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMIN | Contract Administrator Service code 13 | — | $2.6M |
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 | 4,581 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 23 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 218 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,822 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL INSURANCE COMPANY | 8,520 | $0 |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 9,251 | $1.6M |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 3,421 | $799K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 3,711 | $1.6M |
| Other(7 contracts, 6 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."
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.