| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PALOMAR INSURANCE CORPORATION3 | P. O. BOX 11128 MONTGOMERY, AL 361110128 | METROPOLITAN LIFE INSURANCE COMPANY | $40K | — | $40K | 12.46% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 604502215 | METROPOLITAN LIFE INSURANCE COMPANY | $15K | $3K | $18K | 5.60% |
| PALOMAR INSURANCE CORPORATION3 | 4525 EXECUTIVE PARK DRIVE SUITE 202 MONTGOMERY, AL 36116 | AFLAC | $6K | — | $6K | 6.58% |
| RANDY B JACKSON3 Filed as: RANDY JACKSON | PO BOX 1550 MILLBROOK, AL 36054 | AFLAC | $4K | $76 | $4K | 4.14% |
| HAROLD Y GROOMS3 | 110 COOSA RIDGE ROAD DEATSVILLE, AL 36022 | AFLAC | $2K | $168 | $2K | 2.66% |
| BRIAN K CHAMBERS3 Filed as: BRIAN K. CHAMBERS | 8 NIGHTWIND COURT COLUMBUS, GA 31909 | AFLAC | $2K | $76 | $2K | 2.23% |
| AMANDA W. TAYLOR3 | 1223 JAMESTOWN DRIVE PRATTVILLE, AL 36067 | AFLAC | $1K | — | $1K | 1.60% |
| CAROL JACKSON3 Filed as: CAROL S. JACKSON | P O BOX 1550 MILLBROOK, AL 36054 | AFLAC | $972 | $144 | $1K | 1.24% |
| LISA MICHELLE JACKSON3 | 4144 RIVEROAKS ROAD MILLBROOK, AL 36054 | AFLAC | $933 | — | $933 | 1.03% |
| SAIC INC3 Filed as: SAIC, INC. | 1639 BRADLEY PARK DRIVE ST 500 BOX 358 COLUMBUS, GA 31904 | AFLAC | $887 | — | $887 | 0.98% |
| KEITH LIN BELICH3 | 8408 TIMBER CREEK DRIVE PIKE ROAD, AL 36064 | AFLAC | $780 | — | $780 | 0.86% |
| CECELIA B MARSHALL3 Filed as: CECELIA B. MARSHALL | 607 OLD CAMP DRIVE PIKE ROAD, AL 36064 | AFLAC | $493 | — | $493 | 0.55% |
| JENNIFER D LIVINGSTON3 Filed as: JENNIFER D. LIVINGSTON | 178 GEORGETOWN DRIVE RINGGOLD, GA 30736 | AFLAC | $317 | — | $317 | 0.35% |
| BETTY JEAN GAMACHE3 | 136 CHARLESTON CT N MONTGOMERY, AL 36117 | AFLAC | $307 | — | $307 | 0.34% |
| NATIONAL BENEFIT SOLUTIONS LLC3 | 4155 LOMAC STREET SUITE G MONTGOMERY, AL 36106 | AFLAC | $169 | — | $169 | 0.19% |
| JEFFREY REED3 | 29167 FLEETA ROAD OPP, AL 36467 | AFLAC | $123 | $15 | $138 | 0.15% |
| RANDY P MONTZ3 Filed as: RANDY P. MONTZ | 29 DOUBLE OAK AVENUE PIKE ROAD, AL 36064 | AFLAC | $103 | — | $103 | 0.11% |
| COLLEEN J. KEARNEY3 | 732 DUVAL DRIVE MONTGOMERY, AL 36109 | AFLAC | $103 | — | $103 | 0.11% |
| JADE LEE DAVIS3 | 203 HICKMAN AVE E KINSTON, AL 36453 | AFLAC | $73 | $4 | $77 | 0.09% |
| BRIAN V ANDREWS3 Filed as: BRIAN V. ANDREWS | 5728 TAMARACK DRIVE PACE, FL 32571 | AFLAC | $40 | $4 | $44 | 0.05% |
| JEFFREY L COLLINS3 Filed as: JEFFREY L. COLLINS | 359 APPLEFORD ROAD HELENA, AL 35080 | AFLAC | $40 | — | $40 | 0.04% |
| JOHN TODD LEE3 | 322 FARMHOUSE ROAD ELLERSLIE, GA 31807 | AFLAC | $39 | — | $39 | 0.04% |
| LISA O HUGHES3 Filed as: LISA O. HUGHES | 2430 COUNTY ROAD 19 N PRATTVILLE, AL 36067 | AFLAC | $39 | — | $39 | 0.04% |
| RONALD D HOWARD3 Filed as: RONALD D. HOWARD | 312 JAMES STREET TALLASSEE, AL 36078 | AFLAC | $36 | — | $36 | 0.04% |
| RICHARD F SHOCKLEY3 Filed as: RICHARD F. SHOCKLEY | 2101 JACOB MAIN STREET COTTONDALE, FL 32431 | AFLAC | $32 | — | $32 | 0.04% |
| KEVIN MICHAEL RICE3 | 529 EDINBURGH WAY DOTHAN, AL 36305 | AFLAC | $31 | — | $31 | 0.03% |
| JAMES D RICHBURG SR3 Filed as: JAMES D. RICHBURG, SR. | 1341 MITCHELL ROAD BRANTLEYE, AL 36009 | AFLAC | $31 | — | $31 | 0.03% |
| SHAKENYA DAVIS3 Filed as: SHAKENYA S. DAVIS | 4155 LOMAC STREET MONTGOMERY, AL 36106 | AFLAC | $30 | — | $30 | 0.03% |
| SPURGEON C SMITH3 Filed as: SPURGEON C. SMITH | 171 DOGWOOD MDWS WETUMPKA, AL 36093 | AFLAC | $25 | — | $25 | 0.03% |
| STAN A SHERLIN3 Filed as: STAN A. SHERLIN | 773 TOWNE LAKE DRIVE MONTGOMERY, AL 36117 | AFLAC | $21 | — | $21 | 0.02% |
| DAVID N DAVIS3 Filed as: DAVID N. DAVIS | 6901 D AND B LANE WING, AL 36483 | AFLAC | $17 | — | $17 | 0.02% |
| EDDIE J TORRES3 Filed as: EDDIE J. TORRES | 84 VIRGO STREET SANTA ROSA BEACH, FL 32459 | AFLAC | $17 | — | $17 | 0.02% |
| DARRIE S SCHLESINGER3 Filed as: DARRIE S. SCHLESINGER | 941 PARK PLACE MACON, GA 31201 | AFLAC | $16 | — | $16 | 0.02% |
| KELVIN MICHAEL RICE3 | 623 WESTBROOK ROAD DOTHAN, AL 36303 | AFLAC | $12 | — | $12 | 0.01% |
| BRIAN E HICKS3 Filed as: BRIAN E. HICKS | 1327 JEWELL AVENUE FRANKLIN, TN 37064 | AFLAC | $10 | — | $10 | 0.01% |
| BARBARA R KOGUT3 Filed as: BARBARA R. KOGUT | 2631 COLUMBIA STREET HOUSTON, TX 77008 | AFLAC | $9 | — | $9 | 0.01% |
| LYNNE HUDGINS MOORE3 | 8650 MINNIE BROWN ROAD SUITE 150 MONTGOMERY, AL 36117 | AFLAC | $9 | — | $9 | 0.01% |
| JOHN W AMOS3 Filed as: JOHN W. AMOS | 10051 VETERANS PARKWAY SUITE B-2 MIDLAND, GA 31820 | AFLAC | $9 | — | $9 | 0.01% |
| JOEL SANDERS3 | 2165 HALCYON BLVD MONTGOMERY, AL 36117 | AFLAC | $8 | — | $8 | 0.01% |
| ANGELA WOODHAM3 | 23 TABERNACLE ROAD HOPE HULL, AL 36043 | AFLAC | $5 | — | $5 | 0.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF ALABAMA EIN 63-0103830 NONE | Contract Administrator; Claims processing Service code 12 | — | $203K |
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 | 235 | Currently employed and enrolled or eligible. |
| Retired/separated still eligible | 99 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 334 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 670 | $321K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 670 | $321K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 670 | $321K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 670 | $321K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 670 | $321K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 670 | $412K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 670 | — |
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.