| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| W RAY WILLIAMS & ASSOC INC.3 Filed as: W RAY WILLIAMS & ASSOC | 200 E SAINT JULIAN STREET SUITE 525 SAVANNAH, GA 31401 | FIDELITY SECURITY SUS | — | $28K | $28K | 11.71% |
| PRITCHARD & JERDEN INC3 Filed as: PRITCHARD & JERDEN | 950 EAST PACES FERRY ROAD NE SUITE 200 ATLANTA, GA 30326 | FIDELITY SECURITY SUS | — | $5K | $5K | 2.16% |
| COWART INSURANCE GROUP, INC.3 Filed as: COWART INSURANCE GROUP | 139 DRAYTON STREET SAVANNAH, GA 31401 | FIDELITY SECURITY SUS | — | $4K | $4K | 1.62% |
| MJ INSURANCE3 Filed as: VARIOUS AGENTS SEE ATTACHEMNT | PO BOX 1365 COLUMBIA, SC 292021365 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $6K | $604 | $6K | 13.20% |
| W RAY WILLIAMS & ASSOC INC.3 Filed as: W RAY WILLIAMS & ASSOC | 200 E ST JULIAN SUITE 525 SAVANNAH, GA 31401 | UNUM LIFE INSURANCE COMAPNY OF AMERICA | $4K | — | $4K | 13.91% |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 167 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 167 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | FIDELITY SECURITY SUS | 84 | $237K |
| Life insurance | UNUM LIFE INSURANCE COMAPNY OF AMERICA | 175 | $29K |
| Long-term disability | UNUM LIFE INSURANCE COMAPNY OF AMERICA | 175 | $29K |
| Prescription drug | FIDELITY SECURITY SUS | 84 | $237K |
| Stop-loss / reinsurancereinsurance | FIDELITY SECURITY SUS | 84 | $237K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 175 | $76K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 175 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.