| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WALLACE WELCH & WILLINGHAM INC3 Filed as: WALLACE DAWSON | 200 GALLERIA PARKWAY ATLANTA, GA 30339 | TRUASSURE INSURANCE COMPANY | $10K | — | $10K | 10.00% |
| ISBI HOLDINGS3 Filed as: ISBI HOLDINGS INC | 3330 HEALY DR SUITE 100 WINSTON SALEM, NC 27103 | TRUASSURE INSURANCE COMPANY | $5K | — | $5K | 5.00% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY SUITE 1950 ATLANTA, GA 30339 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $10K | $0 | $10K | 15.00% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY SUITE 300 ATLANTA, GA 30339 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $4K | $0 | $4K | 6.07% |
| IBSI HOLDINGS INC3 | PO BOX 24337 WINSTON SALEM, NC 27114 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 5.00% |
| IBSI HOLDINGS INC3 | PO BOX 24337 WINSTON SALEM, NC 27114 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $482 | $0 | $482 | 0.69% |
| IMG5 | 2960 NORTH MERIDIAN ST INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $31 | $31 | 0.04% |
| AXA ASSISTANCE, USA5 Filed as: AXA ASSISTANCE USA | 122 SOUTH MICHIGAN AVE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $6 | $6 | 0.01% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES SE INC | 1901 ROXBOROUGH ROAD CHARLOTTE, NC 28211 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $0 | $3K | 5.63% |
| PETER MICHAEL FOLEY JR3 | 150 PAMPLICO LANE MOORESVILLE, NC 28117 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $251 | $2K | 3.41% |
| MELISSA SWARD3 | 4461 NE 30TH AVE LIGHTHOUSE POINT, FL 33064 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $78 | $1K | 2.29% |
| CAROLINA BENEFITS SOURCE INC3 | 4461 NE 30TH AVE LIGHTHOUSE POINT, FL 33064 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $900 | $0 | $900 | 1.48% |
| DAVID MASON DOKELL3 | 159 BEACON DRIVE MOORESVILLE, NC 28117 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $307 | $73 | $380 | 0.63% |
| AFFINITI INC3 | 6813 LINDA LAKE DRIVE CHARLOTTE, NC 28215 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $300 | $0 | $300 | 0.49% |
| JANET S DOHERTY3 | 1001 STARKEY ROAD LARGO, FL 33771 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $154 | $0 | $154 | 0.25% |
| JACK ALLEN NORRIS3 | 2439 DUTCH BRANCH ROAD COLUMBIA, SC 29210 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $127 | $0 | $127 | 0.21% |
| CREATIVE BENEFIT CONSULTANTS INC3 | 18214 102ND WAY S BOCA RATON, FL 33498 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $71 | $34 | $105 | 0.17% |
| WILLIAM T MILLER3 | 2908 OTRANTO ROAD NORTH CHARLESTON, SC 29406 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $78 | $0 | $78 | 0.13% |
| TUCKER RYAN SWARD3 | 200 WILBY DRIVE CHARLOTTE, NC 28270 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $67 | $0 | $67 | 0.11% |
| JESSE ARON SWARD3 | 4461 NE 30 AVE LIGHTHOUSE POINT, FL 33064 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $42 | $22 | $64 | 0.11% |
| DEBRA LEWIS LINGER3 | 4236 WOODLAWN DRIVE RALEIGH, NC 27616 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $61 | $0 | $61 | 0.10% |
| MARK BRANNON SWARD3 | 8250 CARTER CREEK DRIVE CHARLOTTE, NC 28227 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $58 | $0 | $58 | 0.10% |
| CHRISTOPHER JON MAU3 | 6813 LINDA LAKE DR CHARLOTTE, NC 28215 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $48 | $0 | $48 | 0.08% |
| ELITE ADMINISTRATION3 | 313 HARKINS BLUFF DR GREER, SC 29651 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $48 | $0 | $48 | 0.08% |
| BETTER CHOICE HEALTH LLC3 | 4461 NE 30TH AVE LIGHTHOUSE POINT, FL 33064 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $29 | $10 | $39 | 0.06% |
| FOUNDERS FINANCIAL GROUP LLC3 | 737 PLANTATION ROAD LANCASTER, SC 29720 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $24 | $0 | $24 | 0.04% |
| BENEFITS COUNT INC3 Filed as: BENEFITS COUNT LI INC | 1401 CHRISTMAS COURT RALEIGH, NC 27604 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | $3 | $8 | 0.01% |
| KRISTEN BIBLE3 | 5461 TRALEE PLACE RALEIGH, NC 27609 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | $0 | $5 | 0.01% |
| 3C HOLDINGS INC3 | 908 SYDNEY DRIVE CHARLOTTE, NC 28270 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | COMMUNITY EYE CARE | $3K | $0 | $3K | 10.00% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES SE INC | 1901 ROXBOROUGH ROAD CHARLOTTE, NC 28211 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $702 | $0 | $702 | 6.12% |
| PETER MICHAEL FOLEY JR3 | 150 PAMPLICO LANE MOORESVILLE, NC 28117 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $431 | $57 | $488 | 4.25% |
| MELISSA SWARD3 | 4461 NE 30TH AVE LIGHTHOUSE POINT, FL 33064 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $284 | $17 | $301 | 2.62% |
| CAROLINA BENEFITS SOURCE INC3 | 4461 NE 30TH AVE LIGHTHOUSE POINT, FL 33064 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $171 | $0 | $171 | 1.49% |
| DAVID MASON DOKELL3 | 159 BEACON DRIVE MOORESVILLE, NC 28117 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $56 | $17 | $73 | 0.64% |
| AFFINITI INC3 | 6813 LINDA LAKE DRIVE CHARLOTTE, NC 28215 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $65 | $0 | $65 | 0.57% |
| CREATIVE BENEFIT CONSULTANTS INC | 18214 102ND WAY S BOCA RATON, FL 33498 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | $7 | $23 | 0.20% |
| ELITE ADMINISTRATION3 | 313 HARKINS BLUFF DRIVE GREER, SC 29651 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20 | $0 | $20 | 0.17% |
| JANET S DOHERTY3 | 1001 STARKEY ROAD LARGO, FL 33771 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | $0 | $18 | 0.16% |
| JACK ALLEN NORRIS3 | 2439 DUTCH BRANCH ROAD COLUMBIA, SC 29210 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | $0 | $13 | 0.11% |
| JESSE ARON SWARD3 | 4461 NE 30TH AVE LIGHTHOUSE POINT, FL 33064 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | $4 | $12 | 0.10% |
| CHRISTOPHER JON MAU3 | 6813 LINDA LAKE DRIVE CHARLOTTE, NC 28215 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | $0 | $10 | 0.09% |
| FOUNDERS FINANCIAL GROUP LLC3 | 737 PLANTATION ROAD LANCASTER, SC 29720 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | $0 | $10 | 0.09% |
| MARK BRANNON SWARD3 | 8230 CARTER CREEK DRIVE CHARLOTTE, NC 28227 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | $0 | $10 | 0.09% |
| BETTER CHOICE HEALTH LLC3 Filed as: BETTER CHOICE HEALTH INC | 4461 NE 30TH AVE LIGHTHOUSE POINT, FL 33064 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | $3 | $10 | 0.09% |
| WILLIAM T MILLER3 | 2908 OTRANTO ROAD NORTH CHARLESTON, SC 29406 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | $0 | $6 | 0.05% |
| TUCKER RYAN SWARD3 | 200 WILBY DRIVE CHARLOTTE, NC 28270 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $0 | $4 | 0.03% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| TRUSTMARK HEALTH BENEFITS INC EIN 35-1846036 NONE | Other services; Plan Administrator; Claims processing Service code 12 | 400 FIELD DR LAKE FOREST, IL 60045 | $75K |
| DIGITAL INSURANCE INC EIN 58-2522668 NONE | Insurance agents and brokers; Consulting (general) Service code 16 | 200 GALLERIA PKWY SUITE 1950 ATLANTA, GA 30339 | $43K |
| CIGNA PPO EIN 59-1031071 NONE | Claims processing; Other services Service code 12 | 900 COTTAGE GROVE RD BLOOMFIELD, CT 06002 | $28K |
| ACS - A XEROX COMPANY EIN 36-4129784 NONE | Claims processing; Other services Service code 12 | — | $12K |
| COMPSYCH EIN 35-3739783 NONE | Other services Service code 49 | 455 N CITYFRONT PLAZA CHICAGO, IL 60611 | $0 |
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 | 156 | 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) | 156 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 49 | $72K |
| Dental | TRUASSURE INSURANCE COMPANY | 265 | $97K |
| Vision | COMMUNITY EYE CARE | 200 | $27K |
| Life insurance(3 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 205 | $142K |
| Short-term disability(3 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 205 | $142K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 205 | $70K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 265 | — |
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."
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.