| 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 | $27K | — | $27K | 3.55% |
| RANDALL P SATTERFIELD3 | 10550 INDEPENDENCE POINTE PKWY SUITE 203 MATTHEWS, NC 28105 | PRINCIPAL LIFE INSURANCE COMPANY | $8K | — | $8K | 7.36% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP SERVICES LLC | PO BOX 2291 DURHAM, NC 27702 | PRINCIPAL LIFE INSURANCE COMPANY | $5K | $875 | $6K | 5.27% |
| TINA BLUE3 | PO BOX 643 OAKBORO, NC 28129 | AFLAC | $864 | $42 | $906 | 2.48% |
| JANE W FAUST3 | 518 HARRISON DR NW CONCORD, NC 28027 | AFLAC | $489 | — | $489 | 1.34% |
| KAREN S WELLS ZELINSKE3 | 2859 WYNDHAM WAY MELBOURNE, FL 32940 | AFLAC | $435 | — | $435 | 1.19% |
| KANDACE M MCCARTHY3 | 1171 HEAVENS GATE LAKE IN THE HILLS, IL 60156 | AFLAC | $417 | — | $417 | 1.14% |
| DAVID JACOB HOLPER3 | 1828 W 244TH ST TORRANCE, CA 90501 | AFLAC | $188 | — | $188 | 0.51% |
| JONATHAN P DUNN3 | 3337 TWIN RIDGE DR CHARLOTTE, NC 28210 | AFLAC | $164 | $10 | $174 | 0.48% |
| MONICA L LEIVA3 | 556 N ARTESIAN AVE CHICAGO, IL 60612 | AFLAC | $133 | — | $133 | 0.36% |
| DEBORAH JUNE CRISP3 | 1432 WHITMAN DR NW CONCORD, NC 28027 | AFLAC | $117 | $7 | $124 | 0.34% |
| BLAKE A THOMAS JR3 | 845 PINE HILL DR SE SMYRNA, GA 30080 | AFLAC | $106 | — | $106 | 0.29% |
| MICHAEL E MCCARTHY3 | 143 W WARFIELD DR MOORESVILLE, NC 28115 | AFLAC | $74 | — | $74 | 0.20% |
| LISA PORTER3 Filed as: LISA L PORTER | 3221 KINTORE LN CONCORD, NC 28027 | AFLAC | $67 | — | $67 | 0.18% |
| OKSAN K PILAFAS3 | 838 S VILLA AVE VILLA PARK, IL 60181 | AFLAC | $67 | — | $67 | 0.18% |
| THERESA NETTO PHILLIPS3 Filed as: THERESA V REDDING | 530 SINFOLD PARK ST LAS VEGAS, NV 89148 | AFLAC | $58 | — | $58 | 0.16% |
| SUMMER L CAIN3 | 10040 W CHEYENNE AVE UNIT 170-249 LAS VEGAS, NV 89129 | AFLAC | $57 | — | $57 | 0.16% |
| SARAH CHIESA3 | 7838 W RASCHER AVE CHICAGO, IL 60656 | AFLAC | $55 | — | $55 | 0.15% |
| ELIZABETH HARKEY3 Filed as: ELIZABETH F DEMPSEY | 6152 VILLAGE DR NW CHARLOTTE, NC 28202 | AFLAC | $54 | — | $54 | 0.15% |
| WILLIAM P FLEMING3 | 184 MEADOWVIEW RD LEXINGTON, NC 27295 | AFLAC | $50 | — | $50 | 0.14% |
| JV FLORIDA INSURANCE CORP3 | 2821 N OCEAN BLVD APT 305 FT LAUDERDALE, FL 33308 | AFLAC | $46 | — | $46 | 0.13% |
| AMY F KLUTTZ3 | 5496 MOUNT PLEASANT RD S CONCORD, NC 28025 | AFLAC | $45 | — | $45 | 0.12% |
| ISAAC H FAUST JR3 | PO BOX 12889 JACKSON, WY 83002 | AFLAC | $33 | — | $33 | 0.09% |
| J MICHAEL BUTLER3 | 1090 13TH AVE NW HICKORY, NC 28601 | AFLAC | $32 | — | $32 | 0.09% |
| GWEN NICHOLS BUTLER3 | 203 29TH AVE N66 HICKORY, NC 28601 | AFLAC | $31 | — | $31 | 0.08% |
| MICHAEL ROBERT YURCZYK3 | 9616 WYOMING TER S BLOOMINGTON, MN 55438 | AFLAC | $30 | — | $30 | 0.08% |
| DENNIS J CASSENS3 | 4646 E MARRILL RD STE 1 BYRON, IL 61010 | AFLAC | $30 | — | $30 | 0.08% |
| MARK H MAZZA3 | 1070 S RIMWOOD DR ANAHEIM, CA 92807 | AFLAC | $28 | — | $28 | 0.08% |
| ALEXANDER NEJADEH JR3 | PO BOX 2523 SANTA FE SPRINGS, CA 90670 | AFLAC | $28 | — | $28 | 0.08% |
| GERALD A GREENEN3 | 472 N SUGAR GROVE PKWY STE F102 SUGAR GROVE, IL 60554 | AFLAC | $26 | — | $26 | 0.07% |
| ORLANDO R DOBRINCU3 | 837 LINDEN CIR HOFFMAN ESTATES, IL 60169 | AFLAC | $20 | — | $20 | 0.05% |
| CLAY W CAMPBELL3 | 14720 LIBLEN AVE BELLFLOWER, CA 90706 | AFLAC | $19 | — | $19 | 0.05% |
| MK SWAN INC3 | 6610 HARVEST DR PAPILLION, NE 68133 | AFLAC | $17 | — | $17 | 0.05% |
| SHELLY COLE MORGAN3 | 7140 US HIGHWAY 52 SALISBURY, NC 28146 | AFLAC | $16 | — | $16 | 0.04% |
| CASSANDRA GREEN3 | 4276 KATELLA AVE PMB 185 LOS ALAMITOS, CA 90720 | AFLAC | $15 | — | $15 | 0.04% |
| DANIEL E ZECKMAN3 | 1275 SHILOH RD NW STE 2260 KENNESAW, GA 30144 | AFLAC | $15 | — | $15 | 0.04% |
| CHAD L NELSON3 | 5266 N KUFALK LN BYRON, IL 61010 | AFLAC | $15 | — | $15 | 0.04% |
| H HOWARD THOMSON3 | 14938 BARNWALL ST LA MIRADA, CA 90638 | AFLAC | $15 | — | $15 | 0.04% |
| H J SAMAAN INC3 | 477 E BUTTERFIELD RD STE 206 LOMBARD, IL 60148 | AFLAC | $13 | — | $13 | 0.04% |
| ROBERT HESLEP3 | 6680 RIVER ISLAND CIR BUFORD, GA 30518 | AFLAC | $12 | — | $12 | 0.03% |
| SEAN C. ARENS3 Filed as: SEAN C ARENS | 5904 WARNER AVE STE A PMB 127 HUNTINGTON BEACH, CA 92649 | AFLAC | $12 | — | $12 | 0.03% |
| MICHAEL A ORTIZ3 | 740 CHEYENNE LANE ELGIN, IL 60123 | AFLAC | $10 | — | $10 | 0.03% |
| KATHLEEN S HANSON3 | 5460 E EL PARQUE ST LONG BEACH, CA 90815 | AFLAC | $10 | — | $10 | 0.03% |
| RODNEY A MCCLURE3 | 606 REDBUD TER CANTON, GA 30115 | AFLAC | $9 | — | $9 | 0.02% |
| ASHLEY LYNN SHAW3 | 1163 ESTANCIA WOODS LOOP WINDERMERE, FL 34786 | AFLAC | $8 | — | $8 | 0.02% |
| NICHOLAS K. GREEN3 Filed as: NICHOLAS K GREEN | 14811 SAN JOSE AVE PARAMOUNT, CA 90723 | AFLAC | $8 | — | $8 | 0.02% |
| TODD DEVOSS3 Filed as: TODD C DEVOSS | 321 N CLARK ST STE 625 CHICAGO, IL 60654 | 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% |
| M SHUSTER3 | 5250 GRAND AVE STE 14 # 363 GURNEE, IL 60031 | AFLAC | $4 | — | $4 | 0.01% |
| JOSEPH A NASCA3 | 28081 W MAPLE AVE BARRINGTON, IL 60010 | AFLAC | $4 | — | $4 | 0.01% |
| ELENI A NIKOLAS3 | 312 ABBEY COURT CANTON, GA 30115 | AFLAC | $3 | — | $3 | 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% |
| DAVID C CLOUD JR3 | 12 TRENT DR SEROME, GA 30161 | AFLAC | $2 | — | $2 | 0.01% |
| TODD V MASON3 | 1607 W PACIFIC COAST HWY APT 144 WILMINGTON, CA 90744 | AFLAC | $2 | — | $2 | 0.01% |
| JOSEPH A BUZZELLO3 | 14747 N NORTHSIGHT BLVD STE 111-454 SCOTTSDALE, AZ 85260 | AFLAC | $2 | — | $2 | 0.01% |
| DENA JORDAN3 Filed as: DENA L JORDAN | 5753 HIGHWAY 85 N PMB 8179 CRESTVIEW, FL 32536 | AFLAC | $1 | — | $1 | 0.00% |
| DEBORAH A WITHEY3 | 2149 6TH ST NW HICKORY, NC 28601 | AFLAC | $1 | — | $1 | 0.00% |
| JOANNA G MATHERLY3 | 4581 MAJESTIC MEADOWS DRIVE ARRINGTON, TN 37014 | AFLAC | $1 | — | $1 | 0.00% |
| LIVIER MARIA RAMIREZ3 | 1107 FAIR OAKS AVE PMB 882 SOUTH PASADENA, CA 91030 | AFLAC | $1 | — | $1 | 0.00% |
| JULIE W CRAIG3 | 4930 VILLAGE GREEN DRIVE EL DORADO HILLS, CA 95762 | AFLAC | $1 | — | $1 | 0.00% |
| KATRINA D AIKEN3 | 2511 JUDITH ST LYNCHBURG, VA 24501 | 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 | 255 | 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) | 259 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 90 | $748K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 117 | $113K |
| Vision(2 contracts, 2 carriers) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 90 | $785K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 117 | $113K |
| Short-term disability(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 117 | $150K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 90 | $748K |
| Other(2 contracts, 2 carriers) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 90 | $785K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 117 | — |
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.