| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WELLS FARGO INSURANCE SERVICES3 | 3475 PIEDMONT ROAD NE SUITE 800 ATLANTA, GA 30305 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $33K | — | $33K | 8.11% |
| BRUCE PHILLIPS3 | 4100 PACES WALK, UNIT 3103 ATLANTA, GA 30339 | ALLSTATE WORKPLACE DIVISION | $4K | — | $4K | 8.00% |
| WELLS FARGO INSURANCE SERVICES3 | PO BOX 203491 DALLAS, TX 75320 | ALLSTATE WORKPLACE DIVISION | $2K | — | $2K | 3.46% |
| WELLS FARGO INSURANCE SERVICES3 | 3475 PIEDMONT ROAD, SUITE 800 ATLANTA, GA 30305 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | — | $2K | 40.94% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 3650 MANSELL ROAD, SUITE 100 ALPHARETTA, GA 30022 | CONTINENTAL AMERICAN INSURANCE COMPANY | $633 | — | $633 | 16.22% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH STREET HAMMONTON, NJ 08037 | CONTINENTAL AMERICAN INSURANCE COMPANY | $189 | — | $189 | 4.84% |
| JOHN P KOWN II3 Filed as: JOHN P. KOWN II | 1275 SHILOH ROAD, SUITE 2260 KENNESAW, GA 30144 | CONTINENTAL AMERICAN INSURANCE COMPANY | $56 | — | $56 | 1.43% |
| RONALD S SANDERS3 Filed as: RONALD S. SANDERS | 7402 KINGS RIVER COURT HUMBLE, TX 77346 | CONTINENTAL AMERICAN INSURANCE COMPANY | $55 | — | $55 | 1.41% |
| DAVID C CLOUD JR3 Filed as: DAVID C. CLOUD JR. | 89 GEMSTONE LANE ACWORTH, GA 30101 | CONTINENTAL AMERICAN INSURANCE COMPANY | $54 | — | $54 | 1.38% |
| MJ INSURANCE3 Filed as: AMY O'SHIELDS AND VARIOUS AGENTS | 5159 CALGARY DRIVE DOUGLASVILLE, GA 30135 | CONTINENTAL AMERICAN INSURANCE COMPANY | $53 | — | $53 | 1.36% |
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 | 1,861 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 12 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,873 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ALLSTATE WORKPLACE DIVISION | 151 | $44K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 443 | $77K |
| Vision | EYEMED VISION CARE | 2,686 | $110K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,625 | $401K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,625 | $401K |
| Other(3 contracts, 3 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,625 | $449K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,686 | — |
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.