| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BURNETTE INSURANCE AGENCY3 | 3447 LAWRENCEVILLE SUWANEE RD SUWANEE, GA 30024 | UNITED HEALTHCARE INSURANCE COMPANY | — | $126K | $126K | 5.32% |
| BURNETTE INSURANCE AGENCY3 Filed as: BURNETTE INSURANCE AGENCY INC | 3447 LAWRENCEVILLE SUWANEE RD SUWANEE, GA 30024 | METROPOLITAN LIFE INSURANCE COMPANY | $28K | — | $28K | 8.82% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $13K | $3K | $16K | 4.97% |
| BURNETTE INSURANCE AGENCY3 Filed as: BURNETTE INSURANCE AGENCY INC | 3447 LAWRENCEVILLE SUWANEE RD SUWANEE, GA 30024 | UNUM LIFE INSURANCE COMPANY OF AMERICA, INC | $7K | — | $7K | 20.43% |
| BURNETTE INSURANCE AGENCY3 | 3447 LAWRENCEVILLE SUWANEE RD SUWANEE, GA 30024 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | 14.99% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $316 | $2K | 6.07% |
| BURNETTE INSURANCE AGENCY3 | 3447 LAWRENCEVILLE SUWANEE RD SUWANEE, GA 30024 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | 14.98% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $257 | $2K | 6.02% |
| STEPHAN SCEROLER3 | 377 HIGHWAY 21 SUITE 100 MADISONVILLE, LA 70447 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 20.00% |
| BURNETTE INSURANCE AGENCY3 Filed as: BURNETTE INSURANCE AGENCY INC | 3447 LAWRENCEVILLE SUWANEE RD SUWANEE, GA 30024 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 11.45% |
| FORESTER BENEFITS MANAGEMENT LLC3 | 1909 PINNACLE POINT WAY KNOXVILLE, TN 37922 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $542 | — | $542 | 6.17% |
| OPTIBEN LLC3 | 377 HIGHWAY 21 SUITE 100 MADISONVILLE, LA 70447 | RELIANCE STANDARD LIFE INSURANCE COMPANY | -$688 | — | -$688 | -7.83% |
| STEPHAN SCEROLER3 | 377 HIGHWAY 21 SUITE 100 MADISONVILLE, LA 70447 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 20.00% |
| BURNETTE INSURANCE AGENCY3 | 3447 LAWRENCEVILLE SUWANEE RD SUWANEE, GA 30024 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $959 | — | $959 | 11.66% |
| FORESTER BENEFITS MANAGEMENT LLC3 | 1909 PINNACLE POINT WAY KNOXVILLE, TN 37922 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $521 | — | $521 | 6.33% |
| OPTIBEN LLC3 | 377 HIGHWAY 21 SUITE 100 MADISONVILLE, LA 70447 | RELIANCE STANDARD LIFE INSURANCE COMPANY | -$625 | — | -$625 | -7.60% |
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 | 217 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 221 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 528 | $2.4M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 816 | $321K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 816 | $321K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 816 | $321K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 211 | $25K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 215 | $29K |
| Other(4 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 816 | $372K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 816 | — |
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.