| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | AETNA HEALTH, INC. | — | $32K | $32K | 6.21% |
| COLONIAL LIFE & ACCIDENT3 Filed as: COLONIAL LIFE & ACCIDENT INS. CO. | P.O. BOX 1365 COLUMBIA, SC 29202 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $1K | $7K | 15.58% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6K | — | $6K | 14.19% |
| KLD INSURANCE BENEFITS INC3 Filed as: KLD INSURANCE BENEFITS, INC. | 9085 BETHEL RD GAINESVILLE, GA 30506 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $917 | $579 | $1K | 3.48% |
| SHERI L MITCHELL INC3 Filed as: SHERI L. MITCHELL, INC. | 540 BIRNAMWOOD DRIVE SUWANEE, GA 30024 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $646 | $33 | $679 | 1.58% |
| NORMAC SOLUTIONS INC3 Filed as: NORMAC SOLUTIONS, INC. | 3730 EVEREST DR. MONTGOMERY, AL 36106 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $216 | $132 | $348 | 0.81% |
| EOB CONSULTING LLC3 Filed as: EOB CONSULTING, LLC | 2500 NORTHWINDS PARKWAY ALPHARETTA, GA 30009 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $21 | $203 | $224 | 0.52% |
| B V STONE INC3 Filed as: B. V. STONE, INC. | 1800 SUNSET HARBOUR POINTE LAWRENCEVILLE, GA 30043 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $131 | — | $131 | 0.30% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. | $2K | — | $2K | 4.89% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | AETNA LIFE INSURANCE COMPANY | $660 | $141 | $801 | 11.95% |
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 | 121 | 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) | 121 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA HEALTH, INC. | 171 | $511K |
| Dental | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. | 110 | $39K |
| Vision | AETNA LIFE INSURANCE COMPANY | 114 | $7K |
| Life insurance | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 113 | $43K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 113 | $43K |
| Prescription drug | AETNA HEALTH, INC. | 171 | $511K |
| Other | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 113 | $43K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 171 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.