| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| UTIC INSURANCE COMPANY3 | 450 RIVERCHASE PKWY E BIRMINGHAM, AL 35244 | SUN LIFE ASSURANCE COMPANY OF CANADA | $75K | — | $75K | 10.00% |
| PR INSURANCE LLC3 | 113 ADRIS PLACE DOTHAN, AL 36303 | CANOPY INSURANCE CORP | $36K | — | $36K | 10.00% |
| PR INSURANCE LLC3 | 113 ADRES PLACE DOTHAN, AL 36303 | GUARDIAN LIFE | $9K | — | $9K | 9.17% |
| MICHAEL W BERUBE3 Filed as: MICHAEL WILLIAM BERUBE | PO BOX 9825 CANTON, OH 44711 | GUARDIAN LIFE | $3K | — | $3K | 3.06% |
| PR INSURANCE LLC3 | 113 ADRIS PLACE DOTHAN, AL 36303 | GUARDIAN | $2K | — | $2K | 2.79% |
| MICHAEL W BERUBE3 Filed as: MICHAEL WILLIAM BERUBE | PO BOX 9825 CANTON, OH 44711 | GUARDIAN | $822 | — | $822 | 0.93% |
| JO ANN KIRKLAND3 | 436 SOWELL RD DOTHAN, AL 36301 | AFLAC | $2K | — | $2K | 5.08% |
| JOHN DORAN SHEPPARD3 | 407 HONEYSUCKLE RD, STE 200 DOTHAN, AL 36305 | AFLAC | $778 | — | $778 | 2.09% |
| SAIC INC3 | 1639 BRADLEY PARK DRIVE, ST 500 BOX 358 COLUMBUS, GA 31907 | AFLAC | $585 | — | $585 | 1.57% |
| DANIEL S ADAMS3 | 3857 SCOTT CHURCH RD MARIANNA, FL 32448 | AFLAC | $372 | — | $372 | 1.00% |
| MICHAEL FOWLER3 | 2204 EXECUTIVE PARK DR OPELIKA, AL 36801 | AFLAC | $226 | — | $226 | 0.61% |
| MICHELLE S OSTBLOOM3 | PO BOX 936 POOLER, GA 31322 | AFLAC | $177 | — | $177 | 0.48% |
| JULIETTE WEST ADAMS3 | 202 CROWHILL RD TROY, AL 36081 | AFLAC | $149 | — | $149 | 0.40% |
| BRIAN ANDREWS3 | 5728 TAMARACK DR PACE, FL 32571 | AFLAC | $130 | — | $130 | 0.35% |
| CARYLLE L QUINN3 | 6520 CALLE DE LAGO NAVARRE, FL 32566 | AFLAC | $125 | — | $125 | 0.34% |
| ROBERT P FERRONE3 Filed as: ROBERT C MOBLEY | 7139 BROAD RIVER RD IRMO, SC 29063 | AFLAC | $62 | — | $62 | 0.17% |
| LEO P TISA3 | PO BOX 898 NICEVILLE, FL 32588 | AFLAC | $53 | — | $53 | 0.14% |
| LARRY L JENKINS3 Filed as: LARRY JENKINS | 200 N SAINT ANDREWS ST STE 4 DOTHAN, AL 36303 | AFLAC | $48 | — | $48 | 0.13% |
| THOMAS E NORMAN3 | 917 ELDORADO DR DOTHAN, AL 36303 | AFLAC | $47 | — | $47 | 0.13% |
| WALTER KOGUT3 | 2631 COLUMBIA ST HOUSTON, TX 77008 | AFLAC | $46 | — | $46 | 0.12% |
| THE HORTON GROUP3 Filed as: MEGHAN HORTON BOWEN | 8650 MINNIE BROWN RD STE 124 MONTGOMERY, AL 36117 | AFLAC | $45 | — | $45 | 0.12% |
| JOHN TODD LEE3 | 322 FARMHOUSE RD ELLERSLIE, GA 31807 | AFLAC | $35 | — | $35 | 0.09% |
| COY BRYAN KERSEY3 | 6037 LAURELWOOD DR MILTON, FL 32570 | AFLAC | $35 | — | $35 | 0.09% |
| JAMES M PITZ3 Filed as: JAMES K HALL | 71 FOX GLOVE CT CATAULA, GA 31804 | AFLAC | $32 | — | $32 | 0.09% |
| JOCELYN W RICHBURG3 | 102 KIMBERLY ST HEADLAND, AL 36345 | AFLAC | $31 | — | $31 | 0.08% |
| BARBARA R KOGUT3 | 2631 COLUMBIA ST HOUSTON, TX 77008 | AFLAC | $31 | — | $31 | 0.08% |
| PAUL S WATKINS3 | PO BOX 269 TROY, AL 36081 | AFLAC | $28 | — | $28 | 0.08% |
| STAN A SHERLIN3 | 773 TOWNE LAKE DR MONTGOMERY, AL 36117 | AFLAC | $27 | — | $27 | 0.07% |
| BRENDA WALTON HALL3 | 71 FOX GLOVE CT CATAULA, GA 31804 | AFLAC | $26 | — | $26 | 0.07% |
| BRIAN V ANDREWS3 | 5728 TAMARACK DRIVE PACE, FL 32571 | AFLAC | $23 | — | $23 | 0.06% |
| BUCK MAYO JR3 | 209 DAPHNE DR ENTERPRISE, AL 36330 | AFLAC | $22 | — | $22 | 0.06% |
| JOHN MCDONNELL3 Filed as: JOHN R WILLIAMS | 205 FOXRUN TRAIL DOTHAN, AL 36303 | AFLAC | $19 | — | $19 | 0.05% |
| LEWIS K GATHRIGHT JR3 | PO BOX 165 GOOCHLAND, VA 23063 | AFLAC | $16 | — | $16 | 0.04% |
| JOHN W AMOS3 | 10051 VETERANS PKWY STE B-2 MIDLAND, GA 31820 | AFLAC | $13 | — | $13 | 0.03% |
| MARGARET E MAYO3 | 209 DAPHNE DR ENTERPRISE, AL 36330 | AFLAC | $12 | — | $12 | 0.03% |
| BRIAN K CHAMBERS3 | 8 NIGHTWIND CT COLUMBUS, GA 31909 | AFLAC | $11 | — | $11 | 0.03% |
| RICKEY L BOOTHE3 | PO BOX 584 OPP, AL 36467 | AFLAC | $11 | — | $11 | 0.03% |
| LYNNE HUDGINS MOORE3 | 8650 MINNIE BROWN RD STE 150 MONTGOMERY, AL 36117 | AFLAC | $4 | — | $4 | 0.01% |
| CHAMCO LLC3 | 8 NIGHTWIND CT COLUMBUS, GA 31909 | AFLAC | $4 | — | $4 | 0.01% |
| BRIAN E HICKS3 | 2739 AMERICUS DR THOMPSONS STATION, TN 37179 | AFLAC | $3 | — | $3 | 0.01% |
| JOEL SANDERS3 Filed as: JOEL A SANDERS | 2165 HALCYON BLVD MONTGOMERY, AL 36117 | AFLAC | $3 | — | $3 | 0.01% |
| PR INSURANCE LLC3 | 113 ADRIS PLACE DOTHAN, AL 36303 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 11.10% |
| PR INSURANCE LLC3 | 113 ADRIS PLACE DOTHAN, AL 36303 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS AND BLUE SHIELD OF AL EIN 63-0103830 CLAIMS PROCESSOR | Contract Administrator; Claims processing Service code 12 | — | $733K |
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 | 985 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 12 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 997 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CANOPY INSURANCE CORP | 720 | $361K |
| Vision | GUARDIAN | 709 | $88K |
| Life insurance(3 contracts, 2 carriers) | GUARDIAN LIFE | 474 | $127K |
| Short-term disability(2 contracts, 2 carriers) | GUARDIAN LIFE | 474 | $118K |
| Long-term disability(2 contracts, 2 carriers) | GUARDIAN LIFE | 474 | $118K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,051 | $748K |
| Other(4 contracts, 3 carriers) | GUARDIAN LIFE | 474 | $164K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,051 | — |
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.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.