| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GROUP BENEFIT SOLUTIONS3 | 580 DAVIDSON GATEWAY DRIVE DAVIDSON, NC 28036 | STANDARD INSURANCE COMPANY | $10K | $0 | $10K | 11.11% |
| IBSI HOLDINGS INC3 Filed as: IBSI HOLDING | 1381 OLD MILL CIRLCE #301 WINSTON SALEM, NC 27103 | STANDARD INSURANCE COMPANY | $5K | $0 | $5K | 5.78% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES SE NC | 1901 ROXBOROUGH ROAD CHARLOTTE, NC 28211 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $0 | $5K | 8.31% |
| PETER MICHAEL FOLEY JR3 | 150 PAMPLICO LANE MOORESVILLE, NC 28117 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $1K | $5K | 7.62% |
| CAROLINA BENEFITS SOURCE INC3 | 4461 NE 30TH AVE LIGHTHOUSE PT, FL 33064 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $0 | $3K | 4.00% |
| DAVID MASON DOKELL3 | 127 GREAT POINT DR MOORESVILLE, NC 28117 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $724 | $208 | $932 | 1.49% |
| ELITE ADMINISTRATION3 | 313 HARKINS BLUFF DR GREER, SC 29651 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $497 | $317 | $814 | 1.30% |
| AFFINITI INC3 | 6813 LINDA LAKE DR CHARLOTTE, NC 28215 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $467 | $0 | $467 | 0.74% |
| MARK BRANNON SWARD3 | 8230 CARTER CREEK DR CHARLOTTE, NC 28227 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $284 | $5 | $289 | 0.46% |
| JANET S DOHERTY3 | 26 PEARL STREET WEST SIDNEY, NY 13838 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $29 | $85 | $114 | 0.18% |
| ROLANDO HIRAM DORTA3 | 3011 PISGAH PLACE GREENSBORO, NC 27455 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $109 | $0 | $109 | 0.17% |
| WILLIAM T MILLER3 | 2908 OTRANTO ROAD NORTH CHARLESTON, SC 29406 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $84 | $0 | $84 | 0.13% |
| FOUNDERS FINANCIAL GROUP LLC3 | 737 PLANTATION RD LANCASTER, SC 29720 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $49 | $0 | $49 | 0.08% |
| DOUGLAS R. KILLIAN3 Filed as: DOUGLAS RICHARD KILLIAN | PO BOX 443 STOKESDALE, NC 27357 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | $0 | $8 | 0.01% |
| TIM JARRELL3 | 301 S ELM ST GREENSBORO, NC 27401 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | $0 | $8 | 0.01% |
| GROUP BENEFIT SOLUTIONS3 | 580 DAVIDSON GATEWAY DRIVE DAVIDSON, NC 28036 | STANDARD INSURANCE COMPANY | $6K | $0 | $6K | 19.53% |
| IBSI HOLDINGS INC3 Filed as: IBSI HOLDING | 1381 OLD MILL CIRLCE #301 WINSTON SALEM, NC 27103 | STANDARD INSURANCE COMPANY | $2K | $0 | $2K | 6.89% |
| GROUP BENEFIT SOLUTIONS3 | 580 DAVIDSON GATEWAY DRIVE DAVIDSON, NC 28036 | COMMUNITY EYE CARE | $3K | $0 | $3K | 10.00% |
| GROUP BENEFIT SOLUTIONS3 | 580 DAVIDSON GATEWAY DRIVE DAVIDSON, NC 28036 | STANDARD INSURANCE COMPANY | $4K | $0 | $4K | 19.34% |
| IBSI HOLDINGS INC3 Filed as: IBSI HOLDING | 1381 OLD MILL CIRLCE #301 WINSTON SALEM, NC 27103 | STANDARD INSURANCE COMPANY | $1K | $0 | $1K | 6.81% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES SE INC | 190 ROXBOROUGH ROAD CHARLOTTE, NC 28211 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $231 | $0 | $231 | 3.94% |
| PETER MICHAEL FOLEY JR3 | 150 PAMPLICO LANE MOORESVILLE, NC 28177 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $129 | $19 | $148 | 2.52% |
| CAROLINA BENEFITS SOURCE INC3 | 4461 NE 30TH AVE LIGHTHOUSE PT, FL 33064 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $144 | $0 | $144 | 2.45% |
| AFFINITI INC3 | 6813 LINDA LAKE DR CHARLOTTE, NC 28215 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $82 | $0 | $82 | 1.40% |
| DAVID MASON DOKELL3 | 127 GREAT POINT DR MOORESVILLE, NC 28177 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | $3 | $16 | 0.27% |
| WILLIAM T MILLER3 | 2908 OTRANTO ROAD NORTH CHARLESTON, SC 29406 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | $0 | $11 | 0.19% |
| MARK BRANNON SWARD3 | 8230 CARTER CREEK DR CHARLOTTE, NC 28227 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | $0 | $9 | 0.15% |
| ELITE ADMINISTRATION3 | 193 SCHLAFER RD BAINBRIDGE, NC 12733 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | $2 | $5 | 0.09% |
| FOUNDERS FINANCIAL GROUP LLC3 | 737 PLANTATION RD LANCASTER, SC 29720 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $0 | $4 | 0.07% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CORESOURCE EIN 35-1846036 NONE | Claims processing; Other services; Plan Administrator Service code 12 | 5200 SEVENTY-SEVEN CENTER DR 400 CHARLOTTE, NC 28217 | $84K |
| GROUP BENEFIT SOLUTIONS EIN 27-1018705 NONE | Consulting (general); Insurance agents and brokers Service code 16 | 580 DAVIDSON GATEWAY DRIVE DAVIDSON, NC 28036 | $57K |
| CIGNA PPO EIN 59-1031071 NONE | Other services; Claims processing Service code 12 | 11016 RUSHMORE DRIVE STE 300 CHARLOTTE, NC 28277 | $31K |
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 | 200 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 200 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 64 | $69K |
| Dental | STANDARD INSURANCE COMPANY | 204 | $91K |
| Vision | COMMUNITY EYE CARE | 178 | $26K |
| Life insurance(3 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 210 | $101K |
| Short-term disability(2 contracts) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 64 | $69K |
| Long-term disability(3 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 81 | $88K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 200 | $347K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 210 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.