| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCGRIFF INSURANCE SERVICES INC3 | 1825 BARRETT LAKES BLVD. SUITE 320 KENNESAW, GA 30144 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $165K | $5K | $170K | 7.87% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS & WILLIAMS INC | 1825 BARRETT LAKES BLVD. SUITE 320 KENNESAW, GA 30144 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | — | $5K | $5K | 0.21% |
| DIANNE J RAY3 | PO BOX 335 SUNNY SIDE, GA 30284 | AFLAC | $14K | $811 | $15K | 6.15% |
| DEBBIE ST JOHN3 | 44 MAGNOLIA PKWY HAMPTON, GA 30228 | AFLAC | $14K | $466 | $14K | 6.14% |
| THOMAS D BAXTER3 | PO BOX 603 SUNNYSIDE, GA 30284 | AFLAC | $10K | $275 | $10K | 4.41% |
| DONNA M JOHNSON3 | PO BOX 242 FAYETTEVILLE, GA 30214 | AFLAC | $6K | — | $6K | 2.47% |
| ANDY B GLENN II3 | 50 HURT PLZ SE STE 1630 ATLANTA, GA 30303 | AFLAC | $5K | $235 | $5K | 2.17% |
| DONNA M JOHNSON3 | 500 LANIER AVE W, STE 912A FAYETTEVILLE, GA 30214 | AFLAC | $4K | — | $4K | 1.69% |
| DONNA M JOHNSON3 | 27523 PARK DR ORANGE BEACH, AL 36561 | AFLAC | $2K | $117 | $2K | 0.82% |
| ANDY B GLENN II3 | 2281 LAVA RIDGE CT STE 130 ROSEVILLE, CA 95661 | AFLAC | $1K | $40 | $1K | 0.63% |
| MICAH S CASEY3 | 500 LANIER AVE W STE 912A FAYETTEVILLE, GA 30214 | AFLAC | $1K | — | $1K | 0.58% |
| CHRISTOPHER A TUGGLE3 | 119 LAKEVIEW DR S IVEY, GA 31031 | AFLAC | $324 | — | $324 | 0.14% |
| BARRY T FISHER3 | 9662 SPRINGMEADOW DR NEW PORT RICHEY, GA 34655 | AFLAC | $157 | — | $157 | 0.07% |
| DAVID C CLOUD JR3 | 12 TRENT DR SE ROME, GA 30161 | AFLAC | $123 | — | $123 | 0.05% |
| THOMAS ROBERT GIDDENS3 | PO BOX 2517 KENNESAW, GA 30156 | AFLAC | $89 | — | $89 | 0.04% |
| CHRISTOPHER A TUGGLE3 | 1040 HOUNDS EAR RD GREENSBORO, GA 30642 | AFLAC | $88 | — | $88 | 0.04% |
| JONATHAN W MCCUTCHEON3 | 1150 MALLARD LAKE DR BOGART, GA 30622 | AFLAC | $58 | — | $58 | 0.02% |
| DIANNA L HEATLY3 | 122 WHITESTONE DR MCDONOUGH, GA 30253 | AFLAC | $43 | — | $43 | 0.02% |
| JORDAN R VALIMONT BOBO3 | PO BOX 63 EXPERIMENT, GA 30212 | AFLAC | $38 | — | $38 | 0.02% |
| MARTHA J BRYAN3 | 2930 BOMAR RD DOUGLASVILLE, GA 30135 | AFLAC | $35 | — | $35 | 0.01% |
| ALEXANDER B WARD3 | 5194 FOREST VIEW CT SE MABLETON, GA 30126 | AFLAC | $32 | — | $32 | 0.01% |
| TULL COOPER WIGLEY3 | 205 VILLAGE GREEN SQ WINSTON SALEM, NC 27104 | AFLAC | $25 | — | $25 | 0.01% |
| AMY A O SHIELDS3 | 5159 CALGARY DR DOUGLASVILLE, GA 30135 | AFLAC | $25 | — | $25 | 0.01% |
| WILLIAM A GRAHAM COMPANY3 Filed as: WILLIAM AARON DEES | — | AFLAC | $18 | $7 | $25 | 0.01% |
| KAREN L BURGESS3 | 1417 TRAILWOOD DR STE E BENOIT, MS 38725 | AFLAC | $20 | — | $20 | 0.01% |
| CALOB CANOY3 | 998 HIGHWAY 1 BENOIT, MS 38725 | AFLAC | $10 | $7 | $17 | 0.01% |
| JEREMIAH TROY TALTON3 | 309 NEW POINTE STE B RIDGELAND, MS 39157 | AFLAC | $9 | $5 | $14 | 0.01% |
| CAROL DENISE VANBIBBER3 | 4502 WELLINGTON BLVD ALEXANCRIA, LA 71303 | AFLAC | $7 | $5 | $12 | 0.01% |
| RONALD S SANDERS3 | 744 E DENIM TRL SAN TAN VALLEY, AZ 85143 | AFLAC | $9 | — | $9 | 0.00% |
| TULL COOPER WIGLEY3 | 2186 LUSITANO ST DANVILLE, CA 94506 | AFLAC | $8 | — | $8 | 0.00% |
| TERESA REED3 | 1417 TRAILWOOD DR STE E GREENVILLE, MS 38701 | AFLAC | $8 | — | $8 | 0.00% |
| CLAYTON H BENNETT3 | 2950 ASCOT LN ROSWELL, GA 30076 | AFLAC | $6 | — | $6 | 0.00% |
| SUE C TUCKER3 | 9856 US HIGHWAY 29 N CUSSETA, AL 36852 | AFLAC | $6 | — | $6 | 0.00% |
| SCOTT J RUSSELL3 | 15275 LOBLOLLY CT NORTHPORT, AL 35475 | AFLAC | $5 | — | $5 | 0.00% |
| MELYNDA RAY-MCCUTCHEON3 | 1150 MALLARD LAKE DR BOGART, GA 30622 | AFLAC | $4 | — | $4 | 0.00% |
| TARRAH SMITHSON3 Filed as: TARRAH L SMITHSON | 449 TIMBER PL MILTON, GA 30004 | AFLAC | $4 | — | $4 | 0.00% |
| LACY DODD3 | 734 SHADY OAKS CIR OXFORD, MT 38655 | AFLAC | $4 | — | $4 | 0.00% |
| VANESSA C MITCHELL3 | 200 STONE CREEK DR MADISON, MS 39110 | AFLAC | $4 | — | $4 | 0.00% |
| BRITTANY REYNOLDS3 Filed as: BRITTANY D REYNOLDS | 6724 GREEN ISLAND DR COLUMBUS, GA 31904 | AFLAC | $3 | — | $3 | 0.00% |
| STEVEN VORDERLANDWEHR3 | 1599 AMHEARST MILL DR LAWRENCEVILLE, GA 30043 | AFLAC | $3 | — | $3 | 0.00% |
| RICHARD CARTER SR3 Filed as: RICHARD K CARTER SR | 1224 PEACOCK AVE STE 205 COLUMBUS, GA 31906 | AFLAC | $3 | — | $3 | 0.00% |
| LAURA MILLS3 | 404 GALLERIA DR STE 8 OXFORD, MS 38655 | AFLAC | $2 | $1 | $3 | 0.00% |
| RICHARD MICHAEL TIDWELL3 | 5511 KINGSLEY MNR CUMMING, GU 30041 | AFLAC | $2 | — | $2 | 0.00% |
| LOYE W MIMS3 | 79 LARHONDA DR OXFORD, MT 38655 | AFLAC | $2 | — | $2 | 0.00% |
| KRISTEN BULEY3 | 458 SPRING LAKE DR FORTSON, GA 31808 | AFLAC | $2 | — | $2 | 0.00% |
| SAIC INC3 | 4245 MILGEN RD COLUMBUS, GA 31907 | AFLAC | $2 | — | $2 | 0.00% |
| WILLIAM M WARDLAW JR3 | 5300 OAKBROOK PKWY STE 300 NORCROSS, GA 30093 | AFLAC | $2 | — | $2 | 0.00% |
| THE TILLOTSON GROUP LTD3 | 5000 MASTERS LN COLUMBUS, GA 31909 | AFLAC | $1 | — | $1 | 0.00% |
| CAROL DENISE VANBIBBER3 | 560 LOGGER HEAD LN MANY, LA 71449 | AFLAC | $1 | — | $1 | 0.00% |
| DAVID W WOODS3 | 432 GRAYSPORT RD WINONA, MS 38967 | AFLAC | $1 | — | $1 | 0.00% |
| MARK L ROZYCKI3 | 121 PIN OAK WAY HAMILTON, GA 31811 | AFLAC | $1 | — | $1 | 0.00% |
| DUSTIN ROBERT JOHNSON3 | 50 HURT PLZ SE STE 1630 ATLANTA, GA 30303 | AFLAC | $1 | — | $1 | 0.00% |
| RYAN E MCPHAIL3 | 206 ARBOR CT CANTON, GA 30114 | AFLAC | $1 | — | $1 | 0.00% |
| SAIC INC3 | 1639 BRADLEY PARK DR ST 500 BOX 358 COLUMBUS, GA 31904 | AFLAC | $1 | — | $1 | 0.00% |
| WILLIAM L AMOS & CO INC3 | 6801 RIVER RD STE 205 COLUMBUS, GA 31904 | AFLAC | $1 | — | $1 | 0.00% |
| MCGRIFF INSURANCE SERVICES INC3 | 414 GALLIMORE DAIRY ROAD SUITE F GREENSBORO, NC 27409 | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. | $17K | — | $17K | 12.00% |
| MCGRIFF INSURANCE SERVICES INC3 | 1104 AMHERST ST WINCHESTER, VA 22601 | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | $4K | $873 | $5K | 12.47% |
| DEBBIE ST JOHN3 | 44 MAGNOLIA PKWY HAMPTON, GA 30228 | AFLAC | $3K | $82 | $3K | 11.87% |
| THOMAS D BAXTER3 | PO BOX 603 SUNNY SIDE, GA 30284 | AFLAC | $2K | $41 | $2K | 7.31% |
| DIANNE J RAY3 | PO BOX 335 SUNNY SIDE, GA 30284 | AFLAC | $2K | $41 | $2K | 6.35% |
| DONNA M JOHNSON3 | PO BOX 242 FAYETTEVILLE, GA 30214 | AFLAC | $982 | $82 | $1K | 4.01% |
| MICAH S CASEY3 | 500 LANIER AVE W STE 912A FAYETTEVILLE, GA 30214 | AFLAC | $1K | — | $1K | 3.94% |
| ANDY B GLENN II3 | 50 HURT PLZ SE STE 1630 ATLANTA, GA 30303 | AFLAC | $776 | — | $776 | 2.93% |
| DONNA M JOHNSON3 | 500 LANIER AVE W STE 912A FAYETTEVILLE, GA 30214 | AFLAC | $579 | — | $579 | 2.18% |
| ANDY B GLENN II3 | 2281 LAVA RIDGE CT STE 130 ROSEVILLE, CA 95661 | AFLAC | $434 | $41 | $475 | 1.79% |
| DONNA M JOHNSON3 | 27523 PARK DR ORANGE BEACH, AL 36561 | AFLAC | $362 | — | $362 | 1.37% |
| DIANNE J RAY3 | PO BOX 335 SUNNY SIDE, GA 30284 | AFLAC | $543 | — | $543 | 5.05% |
| THOMAS D BAXTER3 | PO BOX 603 SUNNYSIDE, GA 30284 | AFLAC | $163 | — | $163 | 1.52% |
| DONNA M JOHNSON3 | PO BOX 242 FAYETTEVILLE, GA 30214 | AFLAC | $112 | — | $112 | 1.04% |
| CHRISTOPHER A TUGGLE3 | 119 LAKEVIEW DR S IVEY, GA 31031 | AFLAC | $100 | — | $100 | 0.93% |
| DONNA M JOHNSON3 | 500 LANIER AVE W STE 912A FAYETTEVILLE, GA 30214 | AFLAC | $50 | — | $50 | 0.46% |
| CHRISTOPHER A TUGGLE3 | 1040 HOUNDS EAR RD GREENSBORO, GA 30642 | AFLAC | $42 | — | $42 | 0.39% |
| DAVID C CLOUD JR3 | 12 TRENT DR SE ROME, GA 30161 | AFLAC | $38 | — | $38 | 0.35% |
| ANDY B GLENN II3 | 50 HURT PLZ SE STE 1630 ATLANTA, GA 30303 | AFLAC | $33 | — | $33 | 0.31% |
| DONNA M JOHNSON3 | 27523 PARK DR ORANGE BEACH, AL 36561 | AFLAC | $30 | — | $30 | 0.28% |
| ANDY B GLENN II3 | 2281 LAVA RIDGE CT STE 130 ROSEVILLE, CA 95661 | AFLAC | $15 | — | $15 | 0.14% |
| BARRY T FISHER3 | 9662 SPRINGMEADOW DR NEW PORT RICHEY, FL 34655 | AFLAC | $12 | — | $12 | 0.11% |
| DEBORAH B SMITH3 | 5703 BRYNWOOD CIRCLE NW ACWORTH, GA 30101 | AFLAC | $8 | — | $8 | 0.07% |
| THOMAS ROBERT GIDDENS3 | PO BOX 2517 KENNESAW, GA 30156 | AFLAC | $6 | — | $6 | 0.06% |
| ALEXANDER B WARD3 | 5194 FOREST VIEW CT SE MABLETON, GA 30126 | AFLAC | $4 | — | $4 | 0.04% |
| AMY A O SHIELDS3 | 5159 CALGARY DR DOUGLASVILLE, GA 30135 | AFLAC | $3 | — | $3 | 0.03% |
| RONALD S SANDERS3 | 744 E DENIM TRL SAN TAN VALLEY, AZ 85143 | AFLAC | $3 | — | $3 | 0.03% |
| AMITA PATEL3 | 3455 VICTORY DR COLUMBUS, GA 31903 | AFLAC | $2 | — | $2 | 0.02% |
| JONATHAN W MCCUTCHEON3 | 1150 MALLARD LAKE DR BOGART, GA 30622 | AFLAC | $2 | — | $2 | 0.02% |
| AMITA PATEL3 | 1064 CEDARBROOK DR COLUMBUS, GA 31904 | AFLAC | $1 | — | $1 | 0.01% |
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 | 358 | 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) | 358 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 424 | $2.2M |
| Dental | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. | 308 | $144K |
| Vision | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | 475 | $43K |
| Life insurance | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA, INC. | 475 | $43K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 424 | $2.2M |
| Other(4 contracts, 2 carriers) | AFLAC | 475 | $316K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 475 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.