| 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 | $9K | $0 | $9K | 10.00% |
| ISBI HOLDINGS3 Filed as: ISBI HOLDINGS INC | 3330 HEALY DR SUITE 100 WINSTON SALEM, NC 27103 | TRUASSURE INSURANCE COMPANY | $5K | $0 | $5K | 5.00% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $10K | $0 | $10K | 15.00% |
| ISBI HOLDINGS3 Filed as: ISBI HOLDINGS INC | PO BOX 24337 WINSTON SALEM, NC 27114 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 5.00% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 400 GALLERIA PKWY SUITE 300 ATLANTA, GA 30339 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 2.22% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $36 | $36 | 0.05% |
| 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 | 5.32% |
| PETER MICHAEL FOLEY JR3 | 150 PAMPLICO LANE MOORESVILLE, NC 28117 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $159 | $2K | 3.05% |
| MELISSA SWARD3 | 4461 NE 30TH AVE LIGHTHOUSE POINT, FL 33064 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 2.67% |
| CAROLINA BENEFITS SOURCE INC3 | 4461 NE 30TH AVE LIGHTHOUSE POINT, FL 33064 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $637 | $0 | $637 | 1.13% |
| ALIDA MARIA DEL CID3 | 5844 NW 71ST TERRACE PARKLAND, FL 33067 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $293 | $0 | $293 | 0.52% |
| DAVID MASON DOKELL3 | 159 BEACON DR MOORESVILLE, NC 28117 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $234 | $24 | $258 | 0.46% |
| CHRISTOPHER JON MAU3 | 6813 LINDA LAKE DR CHARLOTTE, NC 28215 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $237 | $0 | $237 | 0.42% |
| CREATIVE BENEFIT CONSULTANTS INC3 | 18214 102ND WAY S BOCA RATON, FL 33498 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $109 | $39 | $148 | 0.26% |
| BETTER CHOICE HEALTH LLC3 | 4461 NE 30 AVE LIGHTHOUSE POINT, FL 33064 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $109 | $11 | $120 | 0.21% |
| JANET S DOHERTY3 | 17328 E ADRIATIC PL AURORA, CO 80013 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $120 | $0 | $120 | 0.21% |
| JACK ALLEN NORRIS3 | 2439 DUTCH BRANCH ROAD COLUMBIA, SC 29210 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $92 | $0 | $92 | 0.16% |
| MARK BRANNON SWARD3 | 8230 CARTER CREEK DR CHARLOTTE, NC 28227 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $43 | $0 | $43 | 0.08% |
| FOUNDERS FINANCIAL GROUP LLC3 | 737 PLANTATION RD LANCASTER, SC 29720 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $32 | $11 | $43 | 0.08% |
| WILLIAM T MILLER3 | 2908 OTRANTO ROAD NORTH CHARLESTON, SC 29406 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $41 | $0 | $41 | 0.07% |
| ELITE ADMINISTRATION3 | 313 HARKINS BLUFF DR GREER, SC 29651 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $33 | $0 | $33 | 0.06% |
| ADVANCED BENEFIT SYSTEM INC3 | 145 RIVER LANDING DRIVE DANIEL ISLAND, SC 29492 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $5 | $9 | 0.02% |
| 3C HOLDINGS INC3 | 908 SYDNEY DRIVE CHARLOTTE, NC 28270 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $0 | $0 | $0 | 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 | 901 ROXBOROUGH ROAD CHARLOTTE, NC 28211 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $305 | $0 | $305 | 3.56% |
| PETER MICHAEL FOLEY JR3 | 150 PAMPLICO LANE MOORESVILLE, NC 28117 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $173 | $3 | $176 | 2.05% |
| CAROLINA BENEFITS SOURCE INC3 | 4461 NE 30TH AVE LIGHTHOUSE POINT, FL 33064 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $132 | $0 | $132 | 1.54% |
| MELISSA SWARD3 | 4461 NE 30TH AVE LIGHTHOUSE POINT, FL 33064 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $63 | $0 | $63 | 0.73% |
| CHRISTOPHER JON MAU3 | 6813 LINDA LAKE DR CHARLOTTE, NC 28215 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $55 | $0 | $55 | 0.64% |
| DAVID MASON DOKELL3 | 159 BEACON DR MOORESVILLE, NC 28117 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17 | $1 | $18 | 0.21% |
| JANET S DOHERTY3 | 17328 E ADRIATIC PL AURORA, CO 80013 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | $0 | $14 | 0.16% |
| ELITE ADMINISTRATION3 | 313 HARKINS BLUFF DR GREER, SC 29651 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | $0 | $14 | 0.16% |
| JACK ALLEN NORRIS3 | 2439 DUTCH BRANCH ROAD COLUMBIA, SC 29210 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | $0 | $12 | 0.14% |
| FOUNDERS FINANCIAL GROUP LLC3 Filed as: FOUNDERS FINACIAL GROUP LLC | 737 PLANTATION RD LANCASTER, SC 29720 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | $0 | $9 | 0.10% |
| MARK BRANNON SWARD3 | 8230 CARTER CREED DR CHARLOTTE, NC 28227 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | $0 | $8 | 0.09% |
| BETTER CHOICE HEALTH LLC3 | 4461 NE 30 AVE LIGHTHOUSE POINT, FL 33064 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $0 | $4 | 0.05% |
| CREATIVE BENEFIT CONSULTANTS INC3 | 18214 102ND WAY S BOCA RATON, FL 33498 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $0 | $4 | 0.05% |
| 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 | $58K |
| DIGITAL INSURANCE, INC. EIN 58-2522668 NONE | Consulting (general); Insurance agents and brokers Service code 16 | 200 GALLERIA PKWY SUITE 1950 ATLANTA, GA 30339 | $41K |
| MEDCOST EIN 56-1999192 NONE | Claims processing; Other services Service code 12 | — | $11K |
| CIGNO PPO EIN 59-1031071 NONE | Other services; Claims processing Service code 12 | 900 COTTAGE GROVE RD BLOOMFIELD, CT 06002 | $6K |
| COMPYSCH 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 | 162 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 162 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 47 | $65K |
| Dental | TRUASSURE INSURANCE COMPANY | 258 | $92K |
| Vision | COMMUNITY EYE CARE | 194 | $32K |
| Life insurance(2 contracts) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 47 | $65K |
| Short-term disability(3 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 174 | $134K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 174 | $69K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 258 | — |
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.