| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COBBS ALLEN & HALL INC3 Filed as: COBBS ALLEN AND HALL INC | 115 OFFICE PARK DR SUITE 200 BIRMINGHAM, AL 35223 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $17K | — | $17K | 11.86% |
| AXA ASSISTANCE, USA5 Filed as: AXA ASSISTANCE USA | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 606036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $49 | $49 | 0.03% |
| MICHAEL HUNTER3 | P.O. BOX 2826 MUSCLE SHOALS, AL 35662 | AFLAC | $3K | $159 | $3K | 7.11% |
| MARILYN HUNTER3 | P.O. BOX 2826 MUSCLE SHOALS, AL 35662 | AFLAC | $2K | — | $2K | 3.62% |
| SAIC INC3 | 1215 MILGEN ROAD COLUMBUS, GA 31907 | AFLAC | $1K | $32 | $1K | 2.47% |
| JOSEPH MCBRIDE3 | 106 AMY LANE MUSCLE SHOALS, AL 35661 | AFLAC | $698 | $32 | $730 | 1.64% |
| R AND L SUPPLEMENTAL BENEFITS INC3 | P.O. BOX 893 FLORENCE, AL 35631 | AFLAC | $480 | — | $480 | 1.08% |
| CATHIE TATE3 | 110 SUMMER WIND CIR MADISON, AL 35758 | AFLAC | $383 | — | $383 | 0.86% |
| STEVEN P MOORE3 Filed as: STEVEN MOORE | 8336 BRITTANY PL MONTGOMERY, AL 36117 | AFLAC | $211 | — | $211 | 0.47% |
| FLOYD GREGORY NAPPS3 Filed as: FLOYD NAPPS | 275 PLANTATION SPRINGS DR FLORENCE, AL 35630 | AFLAC | $156 | — | $156 | 0.35% |
| GIOBANNA GONZALEZ3 | 8028 ORCHARD HILL DRIVE MIDLAND, GA 31820 | AFLAC | $151 | — | $151 | 0.34% |
| JASON L WEEKS3 Filed as: JASON WEEKS | 201 S MAIN ST STE 120 KELLER, TX 76248 | AFLAC | $130 | $17 | $147 | 0.33% |
| GIBBS MORGAN3 | 1004 RIVERSIDE DR APT 1B TUSCALOOSA, AL 35401 | AFLAC | $116 | $15 | $131 | 0.29% |
| MARY ALISON SMITH3 Filed as: MARY SMITH | 123 SPEERS VALLEY RD BRANDON, MS 39042 | AFLAC | $36 | — | $36 | 0.08% |
| ROBERT LOVERN3 | 10150 SAINT FRANCIS DR PHILADELPHIA, MS 39360 | AFLAC | $27 | — | $27 | 0.06% |
| GRAZIA H MILSTEAD3 | PO BOX 730 SHEFFIELD, AL 35660 | AFLAC | $19 | — | $19 | 0.04% |
| RALPH H KEELER3 Filed as: RALPH MANN | 254 SEVILLE ST STE A FLORENCE, AL 35630 | AFLAC | $18 | — | $18 | 0.04% |
| JEANNE T SCHWAB3 Filed as: JEANNE SCHWAB | 2655 MIDDLE RD DAVENPORT, IA 52803 | AFLAC | $16 | — | $16 | 0.04% |
| JOSEPH E PUPEK JR3 Filed as: JOSEPH PUPEK JR | 327 S WALNUT ST FLORENCE, AL 35630 | AFLAC | $14 | — | $14 | 0.03% |
| KEITH A PHILLIPS3 Filed as: KEITH PHILLIPS | P.O. BOX 187 MISSION, KS 66201 | AFLAC | $13 | — | $13 | 0.03% |
| JOY GRUBE PADGELEK3 Filed as: JOY PADGELCK | 1195 WASHINGTON PIKE SUITE 300 BRIDGEVILLE, PA 15017 | AFLAC | $12 | — | $12 | 0.03% |
| TINA M LASSUY3 Filed as: TINA LASSUY | 3021 45TH ST MOLINE, IL 61265 | AFLAC | $9 | — | $9 | 0.02% |
| MICHAEL SHANE KIRKLAND3 Filed as: MICHAEL KIRKLAND | 327 S WALNUT STREET FLORENCE, AL 35630 | AFLAC | $9 | — | $9 | 0.02% |
| THOMAS EDWARD SHEFFIELD3 Filed as: THOMAS SHEFFIELD | P.O. BOX 151 MC COOL JUNCTION, NE 68101 | AFLAC | $6 | — | $6 | 0.01% |
| THE JAMES B OSWALD COMPANY3 Filed as: JAMES ELDRIDGE | 800 GREEN T LK W HERNANDO, MS 38632 | AFLAC | $6 | — | $6 | 0.01% |
| SARAH CHAMPION3 | 505 ENERGY CENTER BLVD SUITE 601 NORTHPORT, AL 35473 | AFLAC | $5 | — | $5 | 0.01% |
| JOHN D LASSUY3 Filed as: JOHN LASSUY | 4544 3RD STREET MOLINE, IL 61265 | AFLAC | $5 | — | $5 | 0.01% |
| ELIZABETH M GASPAROVIC3 Filed as: ELIZABETH GASPAROVIC | 1531 W RUE JAMES PL PALATINE, IL 60067 | AFLAC | $3 | — | $3 | 0.01% |
| D AND V BUTLER INC3 | 601 CRESCENT BLVD STE 102 RIDGELAND, MS 39157 | AFLAC | $3 | — | $3 | 0.01% |
| MICHAEL HUNTER3 | P.O. BOX 2826 MUSCLE SHOALS, AL 356622826 | VISION SERVICE PLAN | $1K | — | $1K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF ALABAMA EIN 63-0103830 CONTRACT ADMINISTRATOR | Claims processing Service code 12 | — | $135K |
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 | 121 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 124 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 43 | $10K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 128 | $141K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 128 | $141K |
| Stop-loss / reinsurancereinsurance | LLOYDS | 121 | $128K |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 128 | $186K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 128 | — |
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.