| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GLENN W BRANTLEY3 Filed as: GLENN W. BRANTLEY | 37 WEST FAIRMONT AVENUE SAVANNAH, GA 31406 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $22K | $118 | $22K | 11.71% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT L. HANNAH | PO BOX 13652 SAVANNAH, GA 31416 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $6K | $322 | $6K | 3.46% |
| BENEFIT COMMUNICATION SPECIALISTS3 | 37 WEST FAIRMONT AVENUE SAVANNAH, GA 31406 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $3K | $6K | 3.17% |
| ADVANCED BENEFIT SYSTEM INC3 Filed as: ADVANCED BENEFIT SYSTEM, INC. | 1301 GERVAIS STREET COLUMBIA, SC 29201 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $1K | $2K | 1.28% |
| MJ INSURANCE3 Filed as: RUSSELL G. JUMP AND VARIOUS AGENTS | 336 PEACHTREE CIRCLE DOUGLAS, GA 31533 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $483 | $64 | $547 | 0.29% |
| CARIE DEANNE CHANEY3 | 37 WEST FAIRMONT AVENUE SAVANNAH, GA 31406 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $373 | $98 | $471 | 0.25% |
| JONI ANN JUMP3 | 336 PEACHTREE CIRCLE DOUGLAS, GA 31533 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $305 | $130 | $435 | 0.23% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 7 EAST CONGRESS STREET, SUITE 1002 SAVANNAH, GA 31401 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $24 | $5K | 9.58% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 3716 NORFOLK, VA 23514 | METROPOLITAN LIFE INSURANCE COMPANY | — | $1K | $1K | 2.19% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSRUANCE SERVICES, LLC | PO BOX 3727 NORFOLK, VA 23514 | EYEMED VISION CARE | $1K | — | $1K | 8.62% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF GEORGIA, INC. | PO BOX 116367 ATLANTA, GA 30383 | EYEMED VISION CARE | $105 | — | $105 | 0.76% |
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 | 250 | 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) | 250 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 137 | $1.1M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 223 | $49K |
| Vision | EYEMED VISION CARE | 178 | $14K |
| Life insurance | AMERICAN UNITED LIFE INSURANCE COMPANY | 196 | $47K |
| Short-term disability | AMERICAN UNITED LIFE INSURANCE COMPANY | 196 | $47K |
| Long-term disability | AMERICAN UNITED LIFE INSURANCE COMPANY | 196 | $47K |
| Prescription drug | UNITED HEALTHCARE INSURANCE COMPANY | 137 | $1.1M |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 196 | $233K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 223 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.