| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MATTHEW WILSON3 | 6135 PARK SOUTH DRIVE SUITE 100 CHARLOTTE, NC 28120 | BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA | $27K | — | $27K | 2.83% |
| JAMES A SCOTT & SON INC3 | 1301 OLD GRAVES MILL ROAD LYNCHBURG, VA 24502 | DELTA DENTAL OF MISSOURI | $7K | — | $7K | 9.08% |
| JAMES A SCOTT & SON INC3 | 1301 OLD GRAVES MILL ROAD LYNCHBURG, VA 24502 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | — | $6K | 15.00% |
| JAMES A SCOTT & SON INC3 | 1301 OLD GRAVES MILL ROAD LYNCHBURG, VA 24502 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 15.00% |
| JAMES A SCOTT & SON INC3 | PO BOX 603438 CHARLOTTE, NC 28260 | HARTFORD LIFE AND ACCIDENT | $3K | — | $3K | 13.48% |
| JAMES A SCOTT & SON INC3 | 1301 OLD GRAVES MILL ROAD LYNCHBURG, VA 24502 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 15.00% |
| JAMES A SCOTT & SON INC3 Filed as: JAMES A. SCOTT & SON, INC | PO BOX 603438 CHARLOTTE, NC 28260 | VISION SERVICE PLAN | $2K | — | $2K | 13.73% |
| JAMES A SCOTT & SON INC3 | 1301 OLD GRAVES MILL ROAD LYNCHBURG, VA 24502 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 15.00% |
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 | 115 | 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) | 115 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA | 31 | $954K |
| Dental | DELTA DENTAL OF MISSOURI | 201 | $74K |
| Vision | VISION SERVICE PLAN | 72 | $12K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 115 | $42K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 115 | $21K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 115 | $28K |
| Other(4 contracts, 3 carriers) | BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA | 115 | $1.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 201 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.