| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT T. CONNOLLY3 | 1801 K STREET NW, SUITE 200 WASHINGTON, DC 20006 | BLUE CROSS AND BLUE SHIELD NORTH CAROLINA | $7K | $0 | $7K | 0.31% |
| MICHAEL BECK3 Filed as: MICHAEL E. BECK | 4819 EMPEROR BOULEVARD, SUITE 200 DURHAM, NC 27703 | BLUE CROSS AND BLUE SHIELD NORTH CAROLINA | $4K | $0 | $4K | 0.18% |
| LOCKTON COMPANIES, LLC3 | PO BOX 415840 BOSTON, MA 02241 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $15K | $2K | $17K | 8.22% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4819 EMPEROR BOULEVARD, SUITE 200 DURHAM, NC 27703 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $0 | $5K | 2.43% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 WEST GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $430 | $430 | 0.20% |
| BENEFITS COUNT INC3 Filed as: BENEFITS COUNT II, INC. | 1401 CHRISTMAS COURT RALEIGH, NC 27604 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $504 | $3K | 5.97% |
| MICHAEL N THORN3 Filed as: MICHAEL N. THORN | 8120 JOSEPH WESTON COURT GREENSBORO, NC 27455 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $519 | $2K | 3.22% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4819 EMPEROR BOULEVARD, SUITE 200 DURHAM, NC 27703 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $5 | $1K | 2.48% |
| ARTHUR WAYNE JORDAN JR3 Filed as: ARTHUR WAYNE JORDAN JR. | 514 OAKWOOD AVENUE RALEIGH, NC 27601 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $875 | $192 | $1K | 2.07% |
| KJELL T TERRELL3 Filed as: KJELL T. TERRELL | 327 GOLF COURSE DRIVE RALEIGH, NC 27610 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $894 | $53 | $947 | 1.84% |
| MJ INSURANCE3 Filed as: KRISTEN BIBLE AND VARIOUS AGENTS | 5461 TRALEE PLACE RALEIGH, NC 27609 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $278 | $0 | $278 | 0.54% |
| TRIAD BENEFITS GROUP INC3 Filed as: TRIAD BENEFITS GROUP, INC. | 200 DOLLY LANE WINSTON SALEM, NC 27107 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $86 | $62 | $148 | 0.29% |
| LOCKTON COMPANIES, LLC3 | PO BOX 417484 BOSTON, MA 02241 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $2K | $0 | $2K | 7.92% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4819 EMPEROR BOULEVARD, SUITE 200 DURHAM, NC 27703 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $660 | $0 | $660 | 3.06% |
| BETTENA WINNICKI4 | UNKNOWN GREENSBORO, NC 27410 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $524 | $0 | $524 | 6.23% |
| PATSY HOLLAND4 | UNKNOWN GREENSBORO, NC 27410 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $249 | $0 | $249 | 2.96% |
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 | 290 | 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) | 290 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD NORTH CAROLINA | 547 | $2.2M |
| Dental | BLUE CROSS AND BLUE SHIELD NORTH CAROLINA | 547 | $2.2M |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 397 | $22K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 290 | $211K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 290 | $263K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 290 | $211K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD NORTH CAROLINA | 547 | $2.2M |
| Other(4 contracts, 4 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 300 | $278K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 547 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.