| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PALOMAR INSURANCE CORPORATION3 | PO BOX 11128 MONTGOMERY, AL 36111 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $38K | — | $38K | 15.00% |
| CHARLES N MADISON3 | 8794 COUNTY ROAD 91 LILLIAN, AL 36549 | AFLAC | $3K | — | $3K | 3.79% |
| BOZEMAN ENTERPRISES INC3 | 4 YACHT CLUB DRIVE 206 DAPHNE, AL 36526 | AFLAC | $2K | $39 | $2K | 3.44% |
| PETE CANARELA3 | 21036A STATE HIGHWAY 181 SUITE 102B FAIRHOPE, AL 36532 | AFLAC | $1K | $8 | $1K | 1.64% |
| WILLIS TOWERS WATSON US LLC3 Filed as: DEBORAH C WILLIS | 27405 POLARIS STREET ORANGE BEACH, AL 36561 | AFLAC | $1K | — | $1K | 1.62% |
| SAIC INC3 | 4245 MILGEN ROAD COLUMBUS, GA 31907 | AFLAC | $932 | — | $932 | 1.36% |
| MICHAEL W OGLESBY3 | 9535 BRISTOW COURT MOBILE, AL 36695 | AFLAC | $534 | — | $534 | 0.78% |
| SAIC INC3 | 4245 MILGEN ROAD COLUMBUS, GA 31907 | AFLAC | $477 | — | $477 | 0.70% |
| RONALD EUGENE WALLACE3 | PO BOX 1355 BAY MINETTE, AL 36507 | AFLAC | $464 | $8 | $472 | 0.69% |
| SUPPLEMENTAL SPECIALISTS INC3 | 25405 PERDIDO BEACH BOULEVARD SUITE 21-226 ORANGE BEACH, AL 36561 | AFLAC | $459 | — | $459 | 0.67% |
| DAVID S JESSE3 | 25232 CREST HAVEN STREET UNIT 1 MURRIETA, CA 92562 | AFLAC | $216 | — | $216 | 0.32% |
| CURTIS W OGLESBY3 | 3615 POTOMAC RIDGE COURT EAST MOBILE, AL 36695 | AFLAC | $215 | — | $215 | 0.31% |
| JACKIE F BURLESON3 | 1124 MARTHA ALLEYN DRIVE SARALAND, AL 36571 | AFLAC | $135 | — | $135 | 0.20% |
| WILLIAM C HAMMOND JR3 | PO BOX 927 JACKSON, AL 36545 | AFLAC | $126 | — | $126 | 0.18% |
| ASHLEY CROOK3 Filed as: ASHLEY L CROOK | 111 DAUPHIN STREET MOBILE, AL 36602 | AFLAC | $73 | — | $73 | 0.11% |
| MARTHA SUE MCGILL3 | 6 YACHT CLUB DRIVE APT 106 DAPHNE, AL 36526 | AFLAC | $42 | — | $42 | 0.06% |
| GEORGIA A SMITH3 | 1367 REAMS DRIVE WEST MOBILE, AL 36608 | AFLAC | $37 | — | $37 | 0.05% |
| JERRY ANN MCCARRON3 | 563 BELLANGEE AVENUE FAIRHOPE, AL 36532 | AFLAC | $35 | — | $35 | 0.05% |
| JOHN TODD LEE3 | 322 FARMHOUSE ROAD ELLERSLIE, GA 31807 | AFLAC | $33 | — | $33 | 0.05% |
| MARK P KNUTSON3 | PO BOX 161 CHANHASSEN, MN 55317 | AFLAC | $32 | — | $32 | 0.05% |
| JOSEPH C ROSA JR3 | 55 SOUTH MONTEREY STREET MOBILE, AL 36604 | AFLAC | $29 | — | $29 | 0.04% |
| WILLIAM RICH CUTTS3 | PO BOX 311112 ENTERPRISE, AL 36331 | AFLAC | $27 | — | $27 | 0.04% |
| CHARLES F EICHELBERGER SR3 | 7192 AFFIRM LANE COLUMBUS, GA 31909 | AFLAC | $23 | — | $23 | 0.03% |
| STAN A SHERLIN3 | 773 TOWNE LAKE DRIVE MONTGOMERY, AL 36117 | AFLAC | $23 | — | $23 | 0.03% |
| RICKEY L BOOTHE3 | PO BOX 584 OPP, AL 36467 | AFLAC | $22 | — | $22 | 0.03% |
| JEANNE BAGGETT3 | 836 MYSTIC PARKWAY SPRING BRANCH, TX 78070 | AFLAC | $21 | — | $21 | 0.03% |
| KARA BLAKE CROPP3 | 3430 RIVER ROAD THEODORE, AL 36582 | AFLAC | $16 | — | $16 | 0.02% |
| PATRICK H JONES3 | 321 ORTLOFF TRAIL NORTHWEST WATERTOWN, MN 55388 | AFLAC | $14 | — | $14 | 0.02% |
| DAVID A JOHNSON3 | 7526 NORTH LAKE DRIVE SPANISH FORT, AL 36527 | AFLAC | $13 | — | $13 | 0.02% |
| NATHAN SUBER3 | 473 NORTH OAKLEY DRIVE COLUMBUS, GA 31906 | AFLAC | $12 | — | $12 | 0.02% |
| BRIAN E HICKS3 | 188 FRONT STREET SUITE 11639 FRANKLIN, TN 37064 | AFLAC | $11 | — | $11 | 0.02% |
| SANDRA D MADISON3 | 8794 COUNTY ROAD 91 LILLIAN, AL 36549 | AFLAC | $9 | — | $9 | 0.01% |
| JONATHON E POINTER3 | 9224 THOROUGHBRED RUN FAIRHOPE, AL 36532 | AFLAC | $7 | — | $7 | 0.01% |
| GEORGE WILLIAMS3 Filed as: GEORGE LOWNDES WILLIAMS | 208 GRAND PARK BOULEVARD CHARLESTON, SC 29492 | AFLAC | $7 | — | $7 | 0.01% |
| JOHN W AMOS3 | 10051 VETERANS PARKWAY #28 MIDLAND, GA 31820 | AFLAC | $5 | — | $5 | 0.01% |
| LYNNE HUDGINS MOORE3 | 8650 MINNIE BROWN ROAD SUITE 150 MONTGOMERY, AL 36117 | AFLAC | $4 | — | $4 | 0.01% |
| JOEL SANDERS3 | 2165 HALCYON BOULEVARD MONTGOMERY, AL 36117 | AFLAC | $3 | — | $3 | 0.00% |
| WILLIAM L AMOS III3 | 6801 RIVER ROAD SUITE 205 COLUMBUS, GA 31904 | AFLAC | $2 | — | $2 | 0.00% |
| JOHN W AMOS3 Filed as: JOHN P THOMPSON JR | 343 SABAL SPRINGS COURT DEBARY, FL 32713 | AFLAC | $1 | — | $1 | 0.00% |
| PALOMAR INSURANCE CORPORATION3 | 4525 EXECUTIVE PARK DRIVE MONTGOMERY, AL 36116 | HARTFORD LIFE AND ACCIDENT | $141 | — | $141 | 14.97% |
| PALOMAR INSURANCE CORPORATION3 | 4525 EXECUTIVE PARK DRIVE MONTGOMERY, AL 36116 | HARTFORD LIFE AND ACCIDENT | $113 | — | $113 | 15.07% |
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 | 199 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 35 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 234 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF ALABAMA | 230 | $3.6M |
| Dental | BLUE CROSS AND BLUE SHIELD OF ALABAMA | 230 | $3.6M |
| Life insurance | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 191 | $254K |
| Long-term disability | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 191 | $254K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF ALABAMA | 230 | $3.6M |
| Other(5 contracts, 4 carriers) | BLUE CROSS AND BLUE SHIELD OF ALABAMA | 230 | $3.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 230 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.