| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOSH WILLIAMS ENTERPRISES INC3 Filed as: JOSH WILLIAMS ENTERPRISES INC. | PO BOX 2287 SKYLAND, NC 28776 | STANDARD INSURANCE COMPANY | $5K | — | $5K | 8.45% |
| AP BENEFIT ADVISORS, LLC3 Filed as: AP BENEFIT ADVISORS LLC | 10 NORTH PARK DRIVE #200 HUNT VALLEY, MD 21030 | STANDARD INSURANCE COMPANY | $4K | — | $4K | 6.55% |
| IBSI HOLDINGS INC3 Filed as: IBSI HOLDING INC. | PO BOX 24337 WINSTON SALEM, NC 27114 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 2.82% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF NC LLC | 119 BROOKSTOWN AVE SUITE 203 WINSTON SALEM, NC 27101 | EQUITABLE FINANCIAL LIFE INSURANCE CO. OF AMERICA | $4K | — | $4K | 6.65% |
| IBSI HOLDINGS INC3 Filed as: IBSI HOLDINGS INC. | PO BOX 24337 WINSTON SALEM, NC 27114 | EQUITABLE FINANCIAL LIFE INSURANCE CO. OF AMERICA | — | $3K | $3K | 5.00% |
| AP BENEFIT ADVISORS, LLC3 Filed as: AP BENEFIT ADVISORS LLC | 718 RIVER RD FAIR HAVEN, NJ 07704 | EQUITABLE FINANCIAL LIFE INSURANCE CO. OF AMERICA | $2K | — | $2K | 3.35% |
| JOSH WILLIAMS ENTERPRISES INC3 Filed as: JOSH WILLIAMS ENTERPRISES INC. | PO BOX 2287 SKYLAND, NC 28776 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 8.66% |
| AP BENEFIT ADVISORS, LLC3 Filed as: AP BENEFIT ADVISORS LLC | 10 NORTH PARK DRIVE SUITE 200 HUNT VALLEY, MD 21030 | STANDARD INSURANCE COMPANY | $1K | — | $1K | 6.34% |
| IBSI HOLDINGS INC3 Filed as: IBSI HOLDING INC. | PO BOX 24337 WINSTON SALEM, NC 27114 | STANDARD INSURANCE COMPANY | $501 | — | $501 | 2.89% |
| JOSH WILLIAMS ENTERPRISES INC3 Filed as: JOSH WILLIAMS ENTERPRISES INC. | PO BOX 2287 SKYLAND, NC 28776 | STANDARD INSURANCE COMPANY | $1K | — | $1K | 8.65% |
| AP BENEFIT ADVISORS, LLC3 Filed as: AP BENEFIT ADVISORS LLC | 10 NORTH PARK DRIVE SUITE 200 HUNT VALLEY, MD 21030 | STANDARD INSURANCE COMPANY | $742 | — | $742 | 6.35% |
| IBSI HOLDINGS INC3 Filed as: IBSI HOLDING INC. | PO BOX 24337 WINSTON SALEM, NC 27114 | STANDARD INSURANCE COMPANY | $337 | — | $337 | 2.88% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF NC EIN 56-0894904 TPA MEDICAL FEES | Contract Administrator; Claims processing Service code 12 | — | $56K |
| MICHAEL BRESLIN MED/RX COMMISSIONS | Claims processing; Contract Administrator Service code 12 | PO BOX 2287 SKYLAND, NC 28776 | $34K |
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 | 128 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 13 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 141 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | EQUITABLE FINANCIAL LIFE INSURANCE CO. OF AMERICA | 114 | $56K |
| Vision | EQUITABLE FINANCIAL LIFE INSURANCE CO. OF AMERICA | 114 | $56K |
| Life insurance | STANDARD INSURANCE COMPANY | 128 | $12K |
| Short-term disability | STANDARD INSURANCE COMPANY | 128 | $64K |
| Long-term disability | STANDARD INSURANCE COMPANY | 56 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 128 | — |
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.