| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | P O BOX 70 WEST POINT, GA 31833 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $17K | $2K | $19K | 10.65% |
| KLD INSURANCE BENEFITS INC3 | 9085 BETHEL RD GAINESVILLE, GA 30506 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $6K | $281 | $6K | 3.65% |
| KLD INSURANCE BENEFITS INC3 | 9085 BETHEL ROAD GAINESVILLE, GA 30506 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $968 | $4K | $5K | 2.77% |
| ELIZABETH LOUISE FENDER3 | 335 S EMERSON AVE INDIANAPOLIS, IN 46219 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $72 | $2K | 1.02% |
| AMY E COHEN3 | 19967 VILLA LANTE PLACE BOCA RATON, FL 33434 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $154 | $1K | 0.84% |
| SABRINA S RAMOS3 | 13750 W COLONIAL DR WINTER GARDEN, FL 34787 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $79 | $1K | 0.78% |
| NORMAC SOLUTIONS INC3 | 3730 EVEREST DR MONTGOMERY, AL 36106 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $24 | $1K | 0.65% |
| MARIA VERONICA JARQUE3 | 4525 GEORGIA ST SAN DIEGO, CA 92116 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $867 | $159 | $1K | 0.58% |
| SANDRA SIMS3 | 13750 W COLONIAL DRIVE SUITE 350 WINTER GARDEN, FL 34787 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $909 | $58 | $967 | 0.55% |
| EOB CONSULTING LLC3 | 2500 NORTHWINDS PARKWAY ALPHARETTA, GA 30009 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $805 | $145 | $950 | 0.54% |
| COLONIAL LIFE BROKERAGE LLC3 | 270 CARPENTER DRIVE ATLANTA, GA 30328 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $347 | $549 | $896 | 0.51% |
| BARBARA J LAKE3 | 226 N HIGH ST MORRISTOWN, IN 46161 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $715 | — | $715 | 0.40% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | 3400 OVERTON PARK DR ATLANTA, GA 30305 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $542 | — | $542 | 0.31% |
| PATRICIA A DUNCAN3 | 520 WHEATFIELD RD FRANKLIN, NC 28734 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $418 | $13 | $431 | 0.24% |
| NORTH FLORIDA BENEFIT SOLUTIONS INC3 | 12659-1 PLUMMER GRANT ROAD JACKSONVILLE, FL 32258 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $358 | $27 | $385 | 0.22% |
| JAMES M EANES3 | 1700 E JACKSON ST PENSACOLA, FL 32501 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $185 | $48 | $233 | 0.13% |
| WILLIAM RENNARD3 | 3001 ALOMA AVE WINTER PARK, FL 32792 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $127 | $106 | $233 | 0.13% |
| DAVID W OTTINGER3 | 111 CURRY HILL RD LEMONT FURNACE, PA 15456 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $207 | $10 | $217 | 0.12% |
| MAGDALENA RUIZ DE GOMEZ3 Filed as: MAGDALENA RUIZE DE GOMEZ | 163 STILLWOOD DRIVE NEWNAN, GA 30265 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $186 | $6 | $192 | 0.11% |
| PEACOCK FINANCIALS INC3 | 6990 GRIFFIN ROAD DAVIE, FL 33314 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $32 | $132 | $164 | 0.09% |
| EMILY PORRECA3 | 146 WINDFIELDS LANE WOODSTOCK, GA 30188 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $46 | $96 | $142 | 0.08% |
| KYLE RUSSEY3 | 6921 E WEDGEWOOD AVENUE DAVIE, FL 33331 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $119 | $22 | $141 | 0.08% |
| JEFFREY LUXENBERG3 | 307 LONGTREE LANE LOGANSPORT, IN 46947 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $46 | $95 | $141 | 0.08% |
| JOE GORDON3 | 5417 WINTHROP AVE INDIANAPOLIS, IN 46220 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $88 | $52 | $140 | 0.08% |
| JEFFREY D BRINDLE3 | 10811 LAKEVIEW DRIVE CARMEL, IN 46033 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $130 | $1 | $131 | 0.07% |
| NORWOOD BENEFIT SERVICES INC3 | 6478 LONG BREEZE RD ORLANDO, FL 32810 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $127 | $1 | $128 | 0.07% |
| ACRISURE LLC3 | 9085 BETHEL ROAD GAINESVILLE, GA 30339 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $120 | — | $120 | 0.07% |
| TULLY AND COMPANY INC3 | 1926 STONE BRIDGE LANE MARIETTA, GA 30064 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $101 | $5 | $106 | 0.06% |
| WENDY DAWN PACK3 | 16109 WATT WAY RAMONA, CA 92065 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $82 | $4 | $86 | 0.05% |
| NORTH FLORIDA BROKER SOLUTIONS LLC3 | 1550 HARRINGTON PARK DRIVE JACKSONVILLE, FL 32225 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $42 | $7 | $49 | 0.03% |
| DARCIPRETE AND ASSOCIATES INC3 | 12945 US HIGHWAY 331 MONTGOMERY, AL 36105 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $18 | $30 | $48 | 0.03% |
| DANA MARIE MOWATT3 | 23701 S WESTERN AVE SUITE 112 TORRANCE, CA 90501 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $41 | $2 | $43 | 0.02% |
| ROBERT H STONE SR3 | 3604 COVENTRY CIRCLE VESTAVIA HILLS, AL 35243 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $17 | $7 | $24 | 0.01% |
| CD FRAZIER ASSOCIATES INC3 | 8631 STONEFACE ROAD CHARLOTTE, NC 28214 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $20 | — | $20 | 0.01% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $19 | — | $19 | 0.01% |
| BENJAMIN ACEVEDO3 | 16211 E GROVECENTER ST COVINA, CA 91722 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $14 | — | $14 | 0.01% |
| BROCKSTAR LLC3 | 2561 FALCON RIDGE DRIVE GRAYSON, GA 30017 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $14 | — | $14 | 0.01% |
| DONNIE HILL LLC3 | P O BOX 10072 HUNTSVILLE, AL 35801 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $8 | $6 | $14 | 0.01% |
| KIMMON R GUSEMAN3 | 48 NICKMAN PLAZA LEMONT FURNACE, PA 15456 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $12 | — | $12 | 0.01% |
| WAYNE RIMMER3 | 7454 FARMERS RD PENSACOLA, FL 32526 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $11 | $1 | $12 | 0.01% |
| LAURIE J BURNS3 | 15 CEDARS EDGE CT BLUFFTON, SC 29910 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $10 | — | $10 | 0.01% |
| MITCHELL HECTOR MORALES3 | 4679 SCORE CT SNELLVILLE, GA 30039 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $9 | — | $9 | 0.01% |
| LAURA B WETT3 | 8194 HYDE AVE SOUTH COTTAGE GROVE, MN 55016 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.00% |
| JENNIFER ROSE SMITH3 | 4920 W SAN RAFAEL ST TAMPA, FL 33629 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.00% |
| YOUNG AGENCY LLC3 | 326 WESLEY CIRCLE MACON, GA 31204 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.00% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 3280 PEACHTREE RD NE ATLANTA, GA 30305 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.00% |
| ERIS VENTURES LLC3 | 931 MONROE DRIVE NE ATLANTA, GA 30308 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.00% |
| JOHN D EVANGELISTA3 | 26111 ANTONIO PARKWAY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2 | $1 | $3 | 0.00% |
| DAVID RUSSELL3 | 228 CAROL DR NEW ALEXANDRIA, PA 15670 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| B V STONE INC3 | 1800 SUNSET HARBOUR POINTE LAWRENCEVILLE, GA 30043 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| PLM SOLUTIONS INC3 | 557 GRAVES ROAD WEDOWEE, AL 36278 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| CAROLE H WARREN3 | 1300 27TH PLACE SOUTH BIRMINGHAM, AL 35205 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: J SMITH LANIER & CO | 11330 LAKEFIELD DRIVE STE 100 BLDG 1 JOHNS CREEK, GA 30097 | METROPOLITAN LIFE INSURANCE COMPANY | $14K | $42 | $14K | 8.30% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN | 250 PEHLE AVE SUITE 400 SADDLEBROOK, NJ 07663 | METROPOLITAN LIFE INSURANCE COMPANY | — | $2K | $2K | 1.04% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: J SMITH LANIER AND COMPANY | 11330 LAKEFIELD DRIVE SUITE 100 BLDG 1 JOHNS CREEK, GA 30097 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $42 | $2K | 8.42% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN | 250 PEHLE AVE SUITE 400 SADDLEBROOK, NJ 07663 | METROPOLITAN LIFE INSURANCE COMPANY | — | $270 | $270 | 1.03% |
| KLD INSURANCE BENEFITS INC3 | 9085 BETHEL RD GAINESVILLE, GA 30506 | THE PAUL REVERE LIFE INSURANCE COMPANY | $10 | — | $10 | 2.32% |
| ACRISURE LLC3 | 13750 W COLONIAL DR WINTER GARDEN, FL 34787 | THE PAUL REVERE LIFE INSURANCE COMPANY | $7 | — | $7 | 1.62% |
| NORMAC SOLUTIONS INC3 | 3730 EVEREST DRIVE MONTGOMERY, AL 36106 | THE PAUL REVERE LIFE INSURANCE COMPANY | $4 | — | $4 | 0.93% |
| SABRINA S RAMOS3 | 13750 W COLONIAL DR WINTER GARDEN, FL 34787 | THE PAUL REVERE LIFE INSURANCE COMPANY | $3 | — | $3 | 0.70% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | THE PAUL REVERE LIFE INSURANCE COMPANY | $1 | — | $1 | 0.23% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTHSCOPE BENEFITS INC CLAIMS ADMIN | Plan Administrator; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 12 | 27 CORPORATE HILL DRIVE LITTLE ROCK, AR 72205 | $1.1M |
| ALIERA HEALTHCARE CLAIMS ADMIN | Claims processing; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Plan Administrator Service code 12 | P O BOX 28220 ATLANTA, GA 30358 | $234K |
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 | 324 | 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) | 324 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 482 | $171K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 424 | $26K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 220 | $178K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 482 | — |
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.