| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RANDALL P SATTERFIELD3 | 10550 INDEPENDENCE POINTE PKWY SUITE 203 MATTHEWS, NC 28105 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $18K | — | $18K | 2.15% |
| RANDALL P SATTERFIELD3 | 10550 INDEPENDENCE POINTE PKWY SUITE 203 MATTHEWS, NC 28105 | PRINCIPAL LIFE INSURANCE COMPANY | $8K | — | $8K | 7.30% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP SERVICES LLC | PO BOX 2291 DURHAM, NC 27702 | PRINCIPAL LIFE INSURANCE COMPANY | $5K | — | $5K | 4.50% |
| TINA BLUE3 | PO BOX 643 OAKBORO, NC 28129 | AFLAC | $2K | $267 | $2K | 4.62% |
| JANE W FAUST3 | 518 HARRISON DR NW CONCORD, NC 28027 | AFLAC | $554 | — | $554 | 1.40% |
| KAREN S WELLS ZELINSKE3 | 2859 WYNDHAM WAY MELBOURNE, FL 32940 | AFLAC | $436 | — | $436 | 1.10% |
| KANDACE M MCCARTHY3 | 1171 HEAVENS GATE LAKE IN THE HILLS, IL 60156 | AFLAC | $357 | — | $357 | 0.90% |
| KANDACE M MCCARTHY3 | 6119 HIGHLAND LN VILLAGE OF LAKEWOOD, IL 60014 | AFLAC | $219 | $134 | $353 | 0.89% |
| JONATHAN P DUNN3 | 3337 TWIN RIDGE DR CHARLOTTE, NC 28210 | AFLAC | $237 | $59 | $296 | 0.75% |
| DEBORAH JUNE CRISP3 | 1432 WHITMAN DR NW CONCORD, NC 28027 | AFLAC | $174 | $15 | $189 | 0.48% |
| DAVID JACOB HOLPER3 | 1828 W 244TH ST TORRANCE, CA 90501 | AFLAC | $175 | $3 | $178 | 0.45% |
| MONICA L LEIVA3 | 556 N ARTESIAN AVE CHICAGO, IL 60612 | AFLAC | $134 | — | $134 | 0.34% |
| MICHAEL E MCCARTHY3 | PO BOX 1047 DUNDEE, IL 60118 | AFLAC | $93 | $31 | $124 | 0.31% |
| BLAKE A THOMAS JR3 Filed as: BLAKE A THOMAS | PINE HILL DR SESMYRNA, FL 30080 | AFLAC | $108 | — | $108 | 0.27% |
| ALEXANDER NEJADEH JR3 | PO BOX 2523 SANTA FE SPRINGS, CA 90670 | AFLAC | $95 | — | $95 | 0.24% |
| LISA PORTER3 Filed as: LISA L PORTER | 210 S MAIN ST APT 450 KANNAPOLIS, NC 28081 | AFLAC | $67 | — | $67 | 0.17% |
| OKSAN K PILAFAS3 | 838 S VILLA AVE VILLA PARK, IL 60181 | AFLAC | $67 | — | $67 | 0.17% |
| SUMMER L CAIN3 | 10040 W CHEYENNE AVE UNIT 170249 LAS VEGAS, NV 89129 | AFLAC | $58 | — | $58 | 0.15% |
| THERESA NETTO PHILLIPS3 Filed as: THERESA V REDDING | 71 COUNTRY CLUB DR BLOOMINGDALE, IL 60108 | AFLAC | $58 | — | $58 | 0.15% |
| ELIZABETH F HARKEY3 | 6152 VILLAGE DR NW CHARLOTTE, NC 28202 | AFLAC | $57 | — | $57 | 0.14% |
| SARAH CHIESA3 | 7838 W RASCHER AVE CHICAGO, IL 60656 | AFLAC | $56 | — | $56 | 0.14% |
| WILLIAM P FLEMING3 | 120 PEARSON DR MORGANTON, NC 28655 | AFLAC | $55 | — | $55 | 0.14% |
| AMY F KLUTTZ3 | 5496 MOUNT PLEASANT RD S CONCORD, NC 28025 | AFLAC | $45 | — | $45 | 0.11% |
| JV FLORIDA INSURANCE CORP3 | 2821 N OCEAN BLVD APT 305 FT LAUDERDALE, FL 33308 | AFLAC | $45 | — | $45 | 0.11% |
| GWEN NICHOLS BUTLER3 | 1090 13TH AVE NW HICKORY, NC 28601 | AFLAC | $37 | — | $37 | 0.09% |
| CLAY W CAMPBELL3 | 14720 LIBLEN AVE BELLFLOWER, CA 90706 | AFLAC | $35 | — | $35 | 0.09% |
| ISAAC H FAUST JR3 | PO BOX 12889 JACKSON, WY 83002 | AFLAC | $35 | — | $35 | 0.09% |
| J MICHAEL BUTLER3 | 1090 13TH AVE NW HICKORY, NC 28601 | AFLAC | $33 | — | $33 | 0.08% |
| DENNIS J CASSENS3 | 4646 E MARRILL RD STE 1 BYRON, IL 61010 | AFLAC | $30 | — | $30 | 0.08% |
| MICHAEL ROBERT YURCZYK3 | 9616 WYOMING TER S BLOOMINGTON, MN 55438 | AFLAC | $29 | — | $29 | 0.07% |
| MARK H MAZZA3 | 1070 S RIMWOOD DR ANAHEIM, CA 92807 | AFLAC | $27 | — | $27 | 0.07% |
| GERALD A GREENEN3 Filed as: GERALD A GREENE | N 1212 S NAPER BLVD STE 119-190 NAPERVILLE, IL 60540 | AFLAC | $25 | — | $25 | 0.06% |
| H HOWARD THOMSON3 | 14938 BARNWALL ST LA MIRADA, CA 90638 | AFLAC | $20 | — | $20 | 0.05% |
| ORLANDO R DOBRINCU3 | 837 LINDEN CIR HOFFMAN ESTATES, IL 60169 | AFLAC | $20 | — | $20 | 0.05% |
| SHELLY COLE MORGAN3 | 7140 US HIGHWAY 52 SALISBURY, NC 28146 | AFLAC | $17 | — | $17 | 0.04% |
| MK SWAN INC3 | 6610 HARVEST DR PAPILLION, NE 68133 | AFLAC | $17 | — | $17 | 0.04% |
| CHAD L NELSON3 | 5266 N KUFALK LN BYRON, IL 61010 | AFLAC | $15 | — | $15 | 0.04% |
| DANIEL E ZECKMAN3 | 1275 SHILOH RD NW STE 2260 KENNESAW, GA 30144 | AFLAC | $14 | — | $14 | 0.04% |
| KATHLEEN S HANSON3 | 5460 E EL PARQUE ST LONG BEACH, CA 90815 | AFLAC | $13 | — | $13 | 0.03% |
| H J SAMAAN INC3 | 477 E BUTTERFIELD RD STE 206 LOMBARD, IL 60148 | AFLAC | $13 | — | $13 | 0.03% |
| CASSANDRA GREEN3 | 4341 MARION AVE CYPRESS, CA 90630 | AFLAC | $13 | — | $13 | 0.03% |
| ROBERT HESLEP3 | 6680 RIVER ISLAND CIR BUFORD, GA 30518 | AFLAC | $12 | — | $12 | 0.03% |
| MATTHEW G BURNSIDE3 | 13309 CANTERBURY CASTLE DR CHARLOTTE, NC 28273 | AFLAC | $11 | — | $11 | 0.03% |
| RODNEY A MCCLURE3 | 606 REDBUD TER CANTON, GA 30115 | AFLAC | $9 | — | $9 | 0.02% |
| MICHAEL A ORTIZ3 | 4119 CORNFLOWER RD POPLAR GROVE, IL 61065 | AFLAC | $9 | — | $9 | 0.02% |
| TODD DEVOSS3 Filed as: TODD C DEVOSS | 321 N CLARK ST STE 625 CHICAGO, IL 60654 | AFLAC | $7 | — | $7 | 0.02% |
| ASHLEY LYNN SHAW3 | 603 E WASHINGTON ST STE 100 INDIANAPOLIS, IN 46204 | AFLAC | $7 | — | $7 | 0.02% |
| ELIZABETH M GASPAROVIC3 | 18 N SMITH ST PALATINE, IL 60067 | AFLAC | $5 | — | $5 | 0.01% |
| KAREN M HUGHES3 | 438 PISGAH PIKE PULASKI, TN 38478 | AFLAC | $5 | — | $5 | 0.01% |
| JOSEPH A BUZZELLO3 | 14747 N NORTHSIGHT BLVD STE 111-454 SCOTTSDALE, AZ 85260 | AFLAC | $5 | — | $5 | 0.01% |
| JOSEPH A NASCA3 | 28081 W MAPLE AVE BARRINGTON, IL 60010 | AFLAC | $4 | — | $4 | 0.01% |
| SCOTT LYDEN3 | 1284 ROSEGATE CT AURORA, IL 60504 | AFLAC | $3 | — | $3 | 0.01% |
| JEFFREY PAUL SEPESI3 | 158 PRINTERS LN NEW LONDON, NC 28127 | AFLAC | $3 | — | $3 | 0.01% |
| EXSEPTIONAL SERVICES INC3 | 158 PRINTERS LN NEW LONDON, NC 28127 | AFLAC | $3 | — | $3 | 0.01% |
| ROBERT L GOBLE3 | 250 34TH AVE NE HICKORY, NC 28601 | AFLAC | $3 | — | $3 | 0.01% |
| M SHUSTER3 | 5250 GRAND AVE STE 14 # 363 GURNEE, IL 60031 | AFLAC | $3 | — | $3 | 0.01% |
| TODD V MASON3 | 1607 W PACIFIC COAST HWY APT 144 WILMINGTON, CA 90744 | AFLAC | $2 | — | $2 | 0.01% |
| MARK D BARBIER3 | 23 CROYDON LN OAK BROOK, IL 60523 | AFLAC | $2 | — | $2 | 0.01% |
| ELENI A NIKOLAS3 | 3869 WINTERGREEN CT MARIETTA, GA 30062 | AFLAC | $2 | — | $2 | 0.01% |
| JACQUELINE CASTRO3 Filed as: JACQUELINE S CASTRO | 131 E 39TH ST APT 3 NEW YORK, NY 10016 | AFLAC | $1 | — | $1 | 0.00% |
| TONY J DELBEN3 | 143 SANDREED DR MOORESVILLE, NC 28117 | AFLAC | $1 | — | $1 | 0.00% |
| ERIC BROGAN3 Filed as: ERIC E MILLER | 728 MERCER PL HUNTERSVILLE, NC 28078 | AFLAC | $1 | — | $1 | 0.00% |
| MEGHAN MOFFATT LUCAS3 Filed as: MEGHAN M MILLER | 728 MERCER PL HUNTERSVILLE, NC 28078 | AFLAC | $1 | — | $1 | 0.00% |
| RYAN E MCPHAIL3 | 206 ARBOR CT CANTON, GA 30114 | AFLAC | $1 | — | $1 | 0.00% |
| RICHARD MICHAEL TIDWELL3 | 5511 KINGSLEY MNR CUMMING, GA 30041 | AFLAC | $1 | — | $1 | 0.00% |
| MICHAEL LEROY COY3 | 6547 N ACADEMY BLVD # 585 COLORADO SPRINGS, CO 80918 | AFLAC | $1 | — | $1 | 0.00% |
| TARRAH SMITHSON3 Filed as: TARRAH L SMITHSON | 2145 SAULS PL ALPHARETTA, GA 30004 | AFLAC | $1 | — | $1 | 0.00% |
| STEVEN VORDERLANDWEHR3 | 1018 HIGHGROVE DR MONROE, GA 30655 | AFLAC | $1 | — | $1 | 0.00% |
| SCOTTI MADISON3 | 3330 COBB PKWY NW STE 324-3 ACWORTH, GA 30101 | AFLAC | $1 | — | $1 | 0.00% |
| DUSTIN ROBERT JOHNSON3 | 745 W BROMPTON AVE APT 1 CHICAGO, IL 60657 | AFLAC | $1 | — | $1 | 0.00% |
| ANNE MARIE HUBBARD3 | 446 MORNING CANYON RD CORONA DEL MAR, CA 92625 | AFLAC | $1 | — | $1 | 0.00% |
| ADAM D ORTIZ3 | 2511 W BRAKER LN APT 423 AUSTIN, TX 78758 | AFLAC | $1 | — | $1 | 0.00% |
| JONATHAN W MCCUTCHEON3 | 1150 MALLARD LAKE DR BOGART, GA 30622 | AFLAC | $1 | — | $1 | 0.00% |
| DEBORAH B SMITH3 | 5703 BRYNWOOD CIR NW ACWORTH, GA 30101 | AFLAC | $1 | — | $1 | 0.00% |
| JACQUELINE GELINAS BEAULIEU3 | 131 E 39TH ST APT 3 NEW YORK, NY 10016 | AFLAC | $1 | — | $1 | 0.00% |
| RONALD S SANDERS3 | 744 E DENIM TRL SAN TAN VALLEY, AZ 85143 | AFLAC | $1 | — | $1 | 0.00% |
| BRIAN W PATTEN3 | 120 MARGUERITE DR STE 101 CRANBERRY TOWNSHIP, PA 16066 | AFLAC | $1 | — | $1 | 0.00% |
| ALLISON FARRIS WENDELBERGER3 | 207 SANTA FE DR WALNUT CREEK, CA 94598 | 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% |
| CASSANDRA GREEN3 | 2698 JUNIPERO AVE STE 201B SIGNAL HILL, CA 90755 | AFLAC | $1 | — | $1 | 0.00% |
| KATRINA D AIKEN3 | 2511 JUDITH ST LYNCHBURG, VA 24501 | AFLAC | $1 | — | $1 | 0.00% |
| JULIE W CRAIG3 | 10722 NW 20TH DR CORAL SPRINGS, FL 33071 | AFLAC | $1 | — | $1 | 0.00% |
| DENA JORDAN3 Filed as: DENA L JORDAN | 9300 HARRIS CORNERS PKWY STE 100 CHARLOTTE, NC 28269 | AFLAC | $1 | — | $1 | 0.00% |
| DEBORAH A WITHEY3 | 2149 6TH ST NW HICKORY, NC 28601 | AFLAC | $1 | — | $1 | 0.00% |
| DAVID C CLOUD JR3 | 12 TRENT DR SEROME, GA 30161 | AFLAC | $1 | — | $1 | 0.00% |
| JOANNA G MATHERLY3 | 2000 GLEN ECHO RD STE 204 NASHVILLE, TN 37215 | AFLAC | $1 | — | $1 | 0.00% |
| LIVIER MARIA RAMIREZ3 | 1107 FAIR OAKS AVE UNIT 882 SOUTH PASADENA, CA 91030 | AFLAC | $1 | — | $1 | 0.00% |
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 | 121 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 121 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 236 | $855K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 159 | $115K |
| Vision(2 contracts, 2 carriers) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 236 | $894K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 159 | $115K |
| Short-term disability(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 159 | $154K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 236 | $855K |
| Other(3 contracts, 3 carriers) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 236 | $1.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 236 | — |
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."
No prospect flags tripped on this filing.