| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EMERSON REID LLC3 | 350 5TH AVE SUITE 3700 NEW YORK, NY 10118 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $12K | $11K | $24K | 19.02% |
| RSC INSURANCE BROKERAGE INC3 | 160 FEDERAL STREET FL 2 BOSTON, MA 02110 | CONTINENTAL AMERICAN INSURANCE COMPANY | $6K | $0 | $6K | 7.59% |
| ANDREW D KOWN3 | 710 CREEKGARDEN COURT ATLANTA, GA 30339 | CONTINENTAL AMERICAN INSURANCE COMPANY | $5K | $0 | $5K | 6.28% |
| FRAN C HARGARTEN III3 | 1140 MOSSY ROCK ROAD NW KENNESAW, GA 30152 | CONTINENTAL AMERICAN INSURANCE COMPANY | $786 | $0 | $786 | 0.95% |
| KAREN H SMITH3 | 145 CHURCH STREET NE SUITE 200 MARIETTA, GA 30060 | CONTINENTAL AMERICAN INSURANCE COMPANY | $417 | $0 | $417 | 0.51% |
| JOHN P KOWN II3 | 1275 SHILOH ROAD SUITE 2260 KENNESAW, GA 30144 | CONTINENTAL AMERICAN INSURANCE COMPANY | $144 | $0 | $144 | 0.17% |
| ADAM T HARRIS3 | 126 HIDDEN LAKE CIRCLE CANTON, GA 30114 | CONTINENTAL AMERICAN INSURANCE COMPANY | $30 | $0 | $30 | 0.04% |
| RONALD S SANDERS3 | 1194 E LAKEVIEW DRIVE SAN TAN VALLEY, AZ 85143 | CONTINENTAL AMERICAN INSURANCE COMPANY | $23 | $0 | $23 | 0.03% |
| DAVID C CLOUD JR3 Filed as: DAVID C CLOUD | 89 GEMSTONE LANE ACWORTH, GA 30101 | CONTINENTAL AMERICAN INSURANCE COMPANY | $4 | $0 | $4 | 0.00% |
| CHARLES S MADISON3 | 3303 COBB PKWY NW SUITE 324-354 ACWORTH, GA 30101 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2 | $0 | $2 | 0.00% |
| RICHARD MICHAEL TIDWELL3 Filed as: RICHARD M TIDWELL | PO BOX 1801 CUMMING, GA 30028 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2 | $0 | $2 | 0.00% |
| RYAN E MCPHAIL3 | 206 ARBOR COURT CANTON, GA 30114 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2 | $0 | $2 | 0.00% |
| AMY A O SHIELDS3 Filed as: AMY A O'SHIELDS | 5159 CALGARY DRIVE DOUGLASVILLE, GA 30135 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2 | $0 | $2 | 0.00% |
| ALEXANDER B WARD3 | 5194 FOREST VIEW COURT SE MABLETON, GA 30126 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2 | $0 | $2 | 0.00% |
| DUSTIN ROBERT JOHNSON3 Filed as: DUSTIN R JOHNSON | 50 HURT PLAZA SE SUITE 995 ATLANTA, GA 30306 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
| STEVEN VORDERLANDWEHR3 | 2219 MCCAHILL COURT BUFORD, GA 30519 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
| EMERSON REID LLC3 | 350 5TH AVE SUITE 3700 NEW YORK, NY 10118 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $11K | $10K | $21K | 27.73% |
| EMERSON REID LLC3 | 350 5TH AVE SUITE 3700 NEW YORK, NY 10118 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $10K | $8K | $17K | 27.31% |
| EMERSON REID LLC3 | 350 5TH AVE SUITE 3700 NEW YORK, NY 10118 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $6K | $14K | 27.48% |
| EMERSON REID LLC3 | 350 5TH AVE SUITE 3700 NEW YORK, NY 10118 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $3K | $6K | 23.23% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BERKLEY LIFE AND HEALTH INSURANCE EIN 91-6034263 STOP LOSS CARRIER | Claims processing Service code 12 | — | $379K |
| RSC INSURANCE BROKERAGE INC EIN 16-1689464 BROKER | Insurance agents and brokers Service code 22 | — | $82K |
| S&S HEALTHCARE STRATEGIES EIN 31-1418743 HRA | Claims processing Service code 12 | — | $74K |
| COVENANT ADMINISTRATORS EIN 58-2015573 MEDICAL TPA | Claims processing Service code 12 | — | $70K |
| CAPTIVE SOLUTIONS & OPTIONS EIN 47-2271845 CAPTIVE | Other fees Service code 99 | 2870 PEACHTREE ROAD #304 ATLANTA, GA 30305 | $46K |
| TELEDOC INC EIN 04-3705970 TELEMEDICINE | Claims processing Service code 12 | — | $2K |
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 | 346 | 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) | 346 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 228 | $124K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 193 | $25K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 169 | $76K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 187 | $50K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 170 | $64K |
| Other(2 contracts, 2 carriers) | CONTINENTAL AMERICAN INSURANCE COMPANY | 346 | $158K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 346 | — |
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.