| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TINA BLUE3 | PO BOX 643 OAKBORO, NC 28129 | AFLAC | $2K | $19 | $2K | 7.75% |
| JANE W FAUST3 | 518 HARRISON DR NW CONCORD, NC 28027 | AFLAC | $320 | — | $320 | 1.01% |
| KAREN S WELLS ZELINSKE3 | 2859 WYNDHAM WAY MELBOURNE, FL 32940 | AFLAC | $283 | — | $283 | 0.89% |
| KANDACE M MCCARTHY3 | 1171 HEAVENS GATE LAKE IN THE HILLS, IL 60156 | AFLAC | $247 | — | $247 | 0.78% |
| BLAKE A THOMAS JR3 | 845 PINEHILL DR SE SMYRNA, GA 30080 | AFLAC | $215 | — | $215 | 0.68% |
| ELIZABETH P HURLEY3 | 20 BARROW AVE NE CONCORD, NC 28025 | AFLAC | $120 | $4 | $124 | 0.39% |
| JONATHAN P DUNN3 | 3337 TWIN RIDGE DR CHARLOTTE, NC 28210 | AFLAC | $105 | — | $105 | 0.33% |
| DEBORAH JUNE CRISP3 | 1432 WHITMAN DR NW CONCORD, NC 28027 | AFLAC | $100 | — | $100 | 0.32% |
| DAVID JACOB HOLPER3 | 1828 W 244TH ST TORRANCE, CA 90501 | AFLAC | $76 | — | $76 | 0.24% |
| SUMMER L CAIN3 | 10040 W CHEYENNE AVE UNIT 170-249 LAS VEGAS, NV 89129 | AFLAC | $62 | — | $62 | 0.20% |
| LISA PORTER3 Filed as: LISA L PORTER | 3221 KINTORE LN CONCORD, NC 28027 | AFLAC | $59 | — | $59 | 0.19% |
| ELIZABETH HARKEY3 Filed as: ELIZABETH F DEMPSEY | 6152 VILLAGE DR NW CHARLOTTE, NC 28202 | AFLAC | $59 | — | $59 | 0.19% |
| SARAH CHIESA3 | 7838 W RASCHER AVE CHICAGO, IL 60656 | AFLAC | $51 | — | $51 | 0.16% |
| AMY F KLUTTZ3 | 5496 MOUNT PLEASANT RD S CONCORD, NC 28025 | AFLAC | $49 | — | $49 | 0.15% |
| MICHAEL E MCCARTHY3 | 143 W WARFIELD DR MOORESVILLE, NC 28115 | AFLAC | $42 | — | $42 | 0.13% |
| ISAAC H FAUST JR3 | PO BOX 12889 JACKSON, WY 83002 | AFLAC | $40 | — | $40 | 0.13% |
| WILLIAM P FLEMING3 | 184 MEADOWVIEW RD LEXINGTON, NC 27295 | AFLAC | $34 | — | $34 | 0.11% |
| DENNIS J CASSENS3 | 4646 E MARRILL RD STE 1 BYRON, IL 61010 | AFLAC | $33 | — | $33 | 0.10% |
| KATIE D ALEXANDER3 | PO BOX 71071 NEWNAN, GA 30271 | AFLAC | $30 | — | $30 | 0.09% |
| MARK H MAZZA3 | 1070 S RIMWOOD DR ANAHEIM, CA 92807 | AFLAC | $30 | — | $30 | 0.09% |
| GERALD A GREENEN3 | 472 N SUGAR GROVE PKWY STE F102 SUGAR GROVE, IL 60554 | AFLAC | $28 | — | $28 | 0.09% |
| AUSTIN J RICE3 | 201 SADDLEHORN TRL BALL GROUND, GA 30107 | AFLAC | $27 | — | $27 | 0.09% |
| GWENDOLYN N BUTLER3 | 203 29TH AVE N66 HICKORY, NC 28601 | AFLAC | $27 | — | $27 | 0.09% |
| J MICHAEL BUTLER3 | 1090 13TH AVE NW HICKORY, NC 28601 | AFLAC | $24 | — | $24 | 0.08% |
| ORLANDO R DOBRINCU3 | 837 LINDEN CIR HOFFMAN ESTATES, IL 60169 | AFLAC | $22 | — | $22 | 0.07% |
| SHELLY COLE MORGAN3 | 7140 US HIGHWAY 52 SALISBURY, NC 28146 | AFLAC | $20 | — | $20 | 0.06% |
| MK SWAN INC3 | 6610 HARVEST DR PAPILLION, NE 68133 | AFLAC | $18 | — | $18 | 0.06% |
| CHAD L NELSON3 | 5266 N KUFALK LN BYRON, IL 61010 | AFLAC | $16 | — | $16 | 0.05% |
| CASSANDRA GREEN3 | 4276 KATELLA AVE PMB 185 LOS ALAMITOS, CA 90720 | AFLAC | $16 | — | $16 | 0.05% |
| JACOB M KIMSEY3 | 101 FOX COVE RD HENDERSONVILLE, NC 28792 | AFLAC | $15 | — | $15 | 0.05% |
| H J SAMAAN INC3 | 477 E BUTTERFIELD RD STE 206 LOMBARD, IL 60148 | AFLAC | $14 | — | $14 | 0.04% |
| ROBERT HESLEP3 | 6680 RIVER ISLAND CIR BUFORD, GA 30518 | AFLAC | $13 | — | $13 | 0.04% |
| CLAY W CAMPBELL3 | 14720 LIBLEN AVE BELLFLOWER, CA 90706 | AFLAC | $9 | — | $9 | 0.03% |
| ASHLEY LYNN SHAW3 | 1163 ESTANCIA WOODS LOOP WINDERMERE, FL 34786 | AFLAC | $8 | — | $8 | 0.03% |
| MICHAEL A ORTIZ3 | 740 CHEYENNE LANE ELGIN, IL 60123 | AFLAC | $7 | — | $7 | 0.02% |
| ROBERT L GOBLE3 | 250 34TH AVE NE HICKORY, NC 28601 | AFLAC | $4 | — | $4 | 0.01% |
| KAREN M HUGHES3 | 438 PISGAH PIKE PULASKI, TN 38478 | AFLAC | $3 | — | $3 | 0.01% |
| ACRISURE LLC3 Filed as: ACRISURE WALLSTREET PARTNERS LLC | 158 PRINTERS LN NEW LONDON, NC 28127 | AFLAC | $3 | — | $3 | 0.01% |
| SCOTT LYDEN3 | 1284 ROSEGATE CT AURORA, IL 60504 | AFLAC | $3 | — | $3 | 0.01% |
| ELENI A NIKOLAS3 | 312 ABBEY CT CANTON, GA 30115 | AFLAC | $3 | — | $3 | 0.01% |
| DEBORAH A WITHEY3 | 2149 6TH ST NW HICKORY, NC 28601 | AFLAC | $3 | — | $3 | 0.01% |
| KATRINA D AIKEN3 | 2511 JUDITH ST LYNCHBURG, VA 24501 | AFLAC | $3 | — | $3 | 0.01% |
| TODD DEVOSS3 Filed as: TODD C DEVOSS | 798 EAGLE DR AURORA, IL 60506 | AFLAC | $2 | — | $2 | 0.01% |
| JULIE W CRAIG3 | 4930 VILLAGE GREEN DR EL DORADO HILLS, CA 95762 | AFLAC | $2 | — | $2 | 0.01% |
| ADAM D ORTIZ3 | 1910 TEAKWOOD DR AUSTIN, TX 78757 | AFLAC | $1 | — | $1 | 0.00% |
| MICHAEL LEROY COY3 | 6547 N ACADEMY BLVD #585 COLORADO SPRINGS, CO 80918 | AFLAC | $1 | — | $1 | 0.00% |
| JOSEPH A NASCA3 | 28081 W MAPLE AVE BARRINGTON, IL 60010 | AFLAC | $1 | — | $1 | 0.00% |
| LIVIER MARIA RAMIREZ3 | 1107 FAIR OAKS AVE PMB 882 SOUTH PASADENA, CA 91030 | AFLAC | $1 | — | $1 | 0.00% |
| DEVOSS INSURANCE AGENCY LLC3 | 798 EAGLE DR AURORA, IL 60506 | AFLAC | $1 | — | $1 | 0.00% |
| DENA JORDAN3 Filed as: DENA JORDAN KILGORE | 5753 HIGHWAY 85 N PMB 8179 CRESTVIEW, FL 32536 | AFLAC | $1 | — | $1 | 0.00% |
| RONALD MOSTO II3 Filed as: RONALD S MOSTO II | 6610 HARVEST DR PAPILLION, NE 68133 | AFLAC | $1 | — | $1 | 0.00% |
| BEAULIEU BENEFITS INC3 | 577 MARITIME WAY SUPPLY, NC 28462 | AFLAC | $1 | — | $1 | 0.00% |
| BRIAN W PATTEN3 | 120 MARGUERITE DR STE 101 CRANBERRY TOWNSHIP, PA 16066 | AFLAC | $1 | — | $1 | 0.00% |
| RONALD S SANDERS3 Filed as: RONALD SCOTT SANDERS | 817 CYPRESS OAK CIR DELAND, FL 32720 | AFLAC | $1 | — | $1 | 0.00% |
| ACRISURE LLC3 Filed as: ACRISURE MIDWEST PART INS SERV LLC | 158 PRINTERS LN NEW LONDON, NC 28127 | AFLAC | $1 | — | $1 | 0.00% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PARKWAY STE 1950 ATLANTA, GA 30339 | SPDO | $3K | — | $3K | 14.34% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DIGITAL INSURANCE NONE | Insurance services Service code 23 | 200 GALLERIA PARKWAY ATLANTA, GA 30339 | $32K |
| SEASHORE INSURANCE & ASSOCIATES INC NONE | Insurance services Service code 23 | 827 GUM BRANCH ROAD JACKSONVILLE, NC 28540 | $10K |
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 | 93 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 97 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE CO. | 115 | $778K |
| Dental | SPDO | 73 | $18K |
| Vision(2 contracts, 2 carriers) | AFLAC | 73 | $50K |
| Short-term disability | AFLAC | 28 | $32K |
| Other | AFLAC | 28 | $32K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 115 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.