| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 8049 CORPORATE CENTER DRIVE CHARLOTTE, NC 28226 | EXCELLUS BLUECROSS BLUESHIELD | $73K | $0 | $73K | 3.58% |
| BENEFIT CONTROLS OF THE CAROLINAS3 | 8049 CORPORATE CENTER DRIVE CHARLOTTE, NC 28226 | EXCELLUS BLUECROSS BLUESHIELD | $453 | $0 | $453 | 0.02% |
| USI INSURANCE SERVICES LLC3 | 333 WESTCHESTER AVENUE, SUITE 102 WHITE PLAINS, NY 10604 | AETNA LIFE INSURANCE COMPANY | $19K | $0 | $19K | 2.23% |
| BENEFIT CONTROLS OF THE CAROLINAS3 | 8049 CORPORATE CENTER DRIVE CHARLOTTE, NC 28226 | AETNA LIFE INSURANCE COMPANY | $9K | $0 | $9K | 1.09% |
| USI INSURANCE SERVICES LLC3 | 200 SUMMIT LAKE DRIVE, SUITE 350 VALHALLA, NY 10595 | AETNA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 0.19% |
| UNKNOWN3 | UNKNOWN STATESVILLE, NC 28625 | AETNA LIFE INSURANCE COMPANY | $846 | $0 | $846 | 0.10% |
| USI INSURANCE SERVICES LLC3 | 100 NE 3RD AVENUE, SUITE 610 FORT LAUDERDALE, FL 33301 | AETNA LIFE INSURANCE COMPANY | $0 | $92 | $92 | 0.01% |
| USI INSURANCE SERVICES LLC3 | 8049 CORPORATE CENTER DRIVE CHARLOTTE, NC 28226 | DELTA DENTAL OF SOUTH DAKOTA | $33K | $0 | $33K | 3.85% |
| PHILLIP GOODRUM3 | 131 HILLSIDE AVENUE CHARLOTTE, NC 28209 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $47K | $0 | $47K | 41.60% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62689 VIRGINIA BEACH, VA 23466 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $20K | $0 | $20K | 17.72% |
| USI INSURANCE SERVICES LLC3 | 8049 CORPORATE CENTER DRIVE CHARLOTTE, NC 28226 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $680 | $87 | $767 | 8.51% |
| BENEFIT COUNT I, INC.3 | 248 RIVERWOOD DRIVE LEWISVILLE, NC 27023 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $275 | $200 | $475 | 5.27% |
| MJ INSURANCE3 Filed as: MELISSA LINDSY AND VARIOUS AGENTS | 152 HARRIS ROAD SMITHFIELD, RI 02917 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $399 | $40 | $439 | 4.87% |
| TAMMY M DAHLBERG3 Filed as: TAMMY M. DAHLBERG | 1009 EIGHTH AVENUE NE WASECA, MN 56093 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $209 | $23 | $232 | 2.57% |
| WHICKERS PARTNERSHIPS, INC.3 | 6775 DORAL DRIVE TABACCOVILLE, NC 27050 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $180 | $29 | $209 | 2.32% |
| ARTHUR WAYNE JORDAN JR3 Filed as: ARTHUR WAYNE JORDAN, JR. | 514 OAKWOOD AVENUE RALEIGH, NC 27601 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $155 | $54 | $209 | 2.32% |
| STEPHEN CORRIVEAU3 | 420 GRANGE ROAD NORTH SMITHFIELD, RI 02896 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $176 | $30 | $206 | 2.29% |
| PHILLIP GOODRUM3 | UNKNOWN STATEVILLE, NC 28625 | ONEAMERICA | $1K | $1K | $3K | 41.21% |
| BENEFIT CONTROLS OF THE CAROLINAS3 | 8049 CORPORATE CENTER DRIVE CHARLOTTE, NC 28226 | ONEAMERICA | $380 | $0 | $380 | 5.53% |
| USI INSURANCE SERVICES LLC3 | 8049 CORPORATE CENTER DRIVE CHARLOTTE, NC 28226 | ONEAMERICA | $239 | $0 | $239 | 3.48% |
| USI INSURANCE SERVICES LLC3 | 333 WESTCHESTER AVENUE, SUITE 102 WHITE PLAINS, NY 10604 | AETNA LIFE INSURANCE COMPANY | $81 | $0 | $81 | 2.28% |
| BENEFIT CONTROLS OF THE CAROLINAS3 | 8049 CORPORATE CENTER DRIVE CHARLOTTE, NC 28226 | AETNA LIFE INSURANCE COMPANY | $0 | $0 | $0 | 0.00% |
| USI INSURANCE SERVICES LLC3 | 8049 CORPORATE CENTER DRIVE CHARLOTTE, NC 28826 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $233 | $30 | $263 | 7.97% |
| TAMMY M DAHLBERG3 Filed as: TAMMY M. DAHLBERG | 1009 EIGHTH AVENUE NE WASECA, MN 56093 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $209 | $23 | $232 | 7.03% |
| BENEFIT COUNT I, INC.3 | 248 RIVERWOOD DRIVE LEWISVILLE, NC 27023 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $89 | $65 | $154 | 4.67% |
| STEPHEN CORRIVEAU3 | 420 GRANGE ROAD NORTH SMITHFIELD, RI 02896 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $54 | $10 | $64 | 1.94% |
| ARTHUR WAYNE JORDAN JR3 Filed as: ARTHUR WAYNE JORDAN, JR. | 514 OAKWOOD AVENUE RALEIGH, NC 27601 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $45 | $19 | $64 | 1.94% |
| MELISSA J LINDSEY3 Filed as: MELISSA J. LINDSEY AND OTHER AGENTS | 152 HARRIS ROAD SMITHFIELD, RI 02917 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $53 | $9 | $62 | 1.88% |
| ENROLLMENT SOLUTIONS LTD3 Filed as: ENROLLMENT SOLUTIONS LIMITED | 14 WUNSCHEL DRIVE SUTTON, MA 01590 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $17 | $6 | $23 | 0.70% |
| USI INSURANCE SERVICES LLC3 | 8049 CORPORATE CENTER DRIVE CHARLOTTE, NC 28226 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $105 | $13 | $118 | 4.26% |
| WHICKERS PARTNERSHIPS, INC.3 | 6775 DORAL DRIVE TABACCOVILLE, NC 27050 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $77 | $12 | $89 | 3.21% |
| BENEFIT COUNT I, INC.3 | 248 RIVERWOOD DRIVE LEWISVILLE, NC 27023 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $45 | $33 | $78 | 2.82% |
| MELISSA J LINDSEY3 Filed as: MELISSA J. LINDSEY AND OTHER AGENTS | 152 HARRIS ROAD SMITHFIELD, RI 02917 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $42 | $0 | $42 | 1.52% |
| ARTHUR WAYNE JORDAN JR3 Filed as: ARTHUR WAYNE JORDAN, JR. | 514 OAKWOOD AVENUE RALEIGH, NC 27601 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $21 | $8 | $29 | 1.05% |
| STEPHEN CORRIVEAU3 | 420 GRANGE ROAD NORTH SMITHFIELD, RI 02896 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $24 | $4 | $28 | 1.01% |
| ENROLLMENT SOLUTIONS LTD3 Filed as: ENROLLMENT SOLUTIONS LIMITED | 14 WUNSCHEL DRIVE SUTTON, MA 01590 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $10 | $2 | $12 | 0.43% |
| USI INSURANCE SERVICES LLC3 | 8049 CORPORATE CENTER DRIVE CHARLOTTE, NC 28226 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $140 | $18 | $158 | 6.15% |
| WHICKERS PARTNERSHIPS, INC.3 | 6775 DORAL DRIVE TABACCOVILLE, NC 27050 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $103 | $16 | $119 | 4.63% |
| BENEFIT COUNT I, INC.3 | 248 RIVERWOOD DRIVE LEWISVILLE, NC 27023 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $63 | $46 | $109 | 4.24% |
| ARTHUR WAYNE JORDAN JR3 Filed as: ARTHUR WAYNE JORDAN, JR. | 514 OAKWOOD AVENUE RALEIGH, NC 27601 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $49 | $11 | $60 | 2.34% |
| STEPHEN CORRIVEAU3 | 420 GRANGE ROAD NORTH SMITHFIELD, RI 02896 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $52 | $6 | $58 | 2.26% |
| MJ INSURANCE3 Filed as: MELISSA LINDSY AND VARIOUS AGENTS | 152 HARRIS ROAD SMITHFIELD, RI 02917 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $47 | $1 | $48 | 1.87% |
| ENROLLMENT SOLUTIONS LTD3 Filed as: ENROLLMENT SOLUTIONS LIMITED | 14 WUNSCHEL DRIVE SUTTON, MA 01590 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $13 | $3 | $16 | 0.62% |
| USI INSURANCE SERVICES LLC3 | 8049 CORPORATE CENTER DRIVE CHARLOTTE, NC 28226 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $76 | $10 | $86 | 6.63% |
| BENEFIT COUNT I, INC.3 | 248 RIVERWOOD DRIVE LEWISVILLE, NC 27023 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $29 | $21 | $50 | 3.86% |
| MELISSA J LINDSEY3 Filed as: MELISSA J. LINDSEY AND OTHER AGENTS | 152 HARRIS ROAD SMITHFIELD, RI 02917 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $27 | $3 | $30 | 2.31% |
| WILLIAM JAMES MURPHY3 | 3016 AMANDA COURT SIOUX FALLS, SD 57106 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $28 | $0 | $28 | 2.16% |
| ANDREW D KRAMER3 Filed as: ANDREW DAVID KRAMER | 6804 EAST STEAMBOAT TRAIL SIOUX FALLS, SD 57110 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $27 | $0 | $27 | 2.08% |
| STEPHEN CORRIVEAU3 | 420 GRANGE ROAD NORTH SMITHFIELD, RI 02896 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $19 | $3 | $22 | 1.70% |
| ARTHUR WAYNE JORDAN JR3 Filed as: ARTHUR WAYNE JORDAN, JR. | 514 OAKWOOD AVENUE RALEIGH, NC 27601 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $14 | $6 | $20 | 1.54% |
| USI INSURANCE SERVICES LLC3 | 8049 CORPORATE CENTER DRIVE CHARLOTTE, NC 28226 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $67 | $8 | $75 | 7.18% |
| BENEFIT COUNT I, INC.3 | 248 RIVERWOOD DRIVE LEWISVILLE, NC 27023 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $27 | $17 | $44 | 4.21% |
| STEPHEN CORRIVEAU3 Filed as: STEPHEN CORRIVEAU AND OTHER AGENTS | 420 GRANGE ROAD NORTH SMITHFIELD, RI 02896 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $30 | $4 | $34 | 3.26% |
| WILLIAM JAMES MURPHY3 | 3016 AMANDA COURT SIOUX FALLS, SD 57106 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $25 | $0 | $25 | 2.39% |
| ANDREW D KRAMER3 Filed as: ANDREW DAVID KRAMER | 6804 EAST STEAMBOAT TRAIL SIOUX FALLS, SD 57110 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $20 | $0 | $20 | 1.92% |
| ARTHUR WAYNE JORDAN JR3 Filed as: ARTHUR WAYNE JORDAN, JR. | 514 OAKWOOD AVENUE RALEIGH, NC 27601 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $13 | $5 | $18 | 1.72% |
| ENROLLMENT SOLUTIONS LTD3 Filed as: ENROLLMENT SOLUTIONS LIMITED | 14 WUNSCHEL DRIVE SUTTON, MA 01590 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5 | $1 | $6 | 0.57% |
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 | 1,832 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 40 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 63 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,935 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EXCELLUS BLUECROSS BLUESHIELD | 193 | $2.0M |
| Dental | DELTA DENTAL OF SOUTH DAKOTA | 2,144 | $854K |
| Vision | VISION SERVICE PLAN | 852 | $159K |
| Life insurance(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 1,832 | $865K |
| Short-term disability | AETNA LIFE INSURANCE COMPANY | 1,832 | $856K |
| Long-term disability | AETNA LIFE INSURANCE COMPANY | 1,832 | $856K |
| Prescription drug | EXCELLUS BLUECROSS BLUESHIELD | 193 | $2.0M |
| Other(10 contracts, 4 carriers) | AETNA LIFE INSURANCE COMPANY | 1,832 | $999K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,144 | — |
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.