| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HCW EMPLOYEE BENEFIT SERVICES, LLC3 Filed as: HCW EMPLOYEE BENEFIT SERVICES LLC | 4819 EMPEROR BOULEVARD STE 200 DURHAM, NC 27703 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | — | $1K | $1K | 0.06% |
| HCW EMPLOYEE BENEFIT SERVICES, LLC3 Filed as: HCW EMPLOYEE BENEFIT SERVICES LLC | 4819 EMPEROR BLVD STE 200 DURHAM, NC 27703 | METROPOLITAN LIFE INSURANCE COMPANY | $15K | — | $15K | 10.97% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 9375 GREENSBORO, NC 27429 | METROPOLITAN LIFE INSURANCE COMPANY | — | $38 | $38 | 0.03% |
| HCW EMPLOYEE BENEFIT SERVICES, LLC3 | 4819 EMPEROR BLVD STE 200 DURHAM, NC 27703 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $2K | $10K | 13.59% |
| HCW EMPLOYEE BENEFIT SERVICES, LLC3 Filed as: HCW EMPLOYEE BENEFIT SERVICES | 4819 EMPEROR BLVD STE 200 DURHAM, NC 27703 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | $1K | $10K | 18.03% |
| HCW EMPLOYEE BENEFIT SERVICES, LLC3 Filed as: HCW EMPLOYEE BENEFIT SERVICES LLC | 4819 EMPEROR BLVD STE 200 DURHAM, NC 27703 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 9.89% |
| BENEFITS COUNT INC3 Filed as: BENEFITS COUNT I INC | 248 RIVERWOOD DR LEWISVILLE, NC 27023 | THE PAUL REVERE LIFE INSURANCE COMPANY | $5 | — | $5 | 1.94% |
| BENEFITS COUNT INC3 Filed as: BENEFITS COUNT II INC | 248 RIVERWOOD DR LEWISVILLE, NC 27023 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7K | $3K | $10K | — |
| KRISTEN BIBLE3 | 4516 LATROBE COURT RALEIGH, NC 27604 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7K | $1K | $9K | — |
| HCW EMPLOYEE BENEFIT SERVICES, LLC3 Filed as: HCW EMPLOYEE BENEFIT SERVICES LLC | 4819 EMPEROR BLVD STE 200 DURHAM, NC 27703 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $114 | $5K | — |
| ARTHUR WAYNE JORDAN JR3 | 306 PACE ST RALEIGH, NE 27604 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $765 | $3K | — |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 9375 GREENSBORO, NC 27429 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $441 | $20 | $461 | — |
| INSYNC BENEFITS INC3 | PO BOX 1474 CORNELIUS, NC 28031 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $319 | $87 | $406 | — |
| ROBERT W. FOXWORTH INC3 Filed as: ROBERT W FOXWORTH | 529 CAYMAN AVENUE HOLLY SPRINGS, NC 27540 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $184 | $64 | $248 | — |
| RYLEE ENTERPRISES INC3 | 1828 OAK RIDGE RD OAK RIDGE, NC 27310 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $141 | — | $141 | — |
| PATRICIA L CARON3 | 190 TESUQUE VILLAGE ROAD SANTA FE, NM 87506 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $98 | — | $98 | — |
| KJELL T TERRELL3 | 327 GOLF COURSE DR RALEIGH, NC 27610 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $55 | — | $55 | — |
| BENEFITS COUNT INC3 Filed as: BENEFITS COUNT I INC | 248 RIVERWOOD DR LEWISVILLE, NC 27023 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $44 | — | $44 | — |
| JACQUELINE BARTHELEMY3 | 7573 HILTON RD ROYALTON, MN 56373 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | — | $16 | — |
| ASSOCIATED FINANCIAL GROUP LLC3 | 711 EISENHOWER DR KIMBERLY, WI 54136 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | — | $16 | — |
| BRAIN FLANNERY3 | 183 WINDSOR GREEN DR CLAYTON, NC 27527 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | — | $14 | — |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | — | $14 | — |
| THOMAS W BOSTON3 Filed as: THOMAS G BANKS | 10901 RIDGEWOOD CT BURNSVILLE, MN 55337 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | — | $8 | — |
| ROBERT A CLOUDT3 | 128 LAUREL DRIVE BARNESVILLE, GA 30204 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | — |
| GLORIA B WHITE3 | 3605 STECK AVE AUSTIN, TX 78759 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | — |
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 | 282 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 289 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 447 | $1.6M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 416 | $140K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 279 | $21K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 247 | $129K |
| Short-term disability(4 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 247 | $129K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 247 | $73K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 447 | $1.6M |
| Other(4 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 247 | $129K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 447 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.