| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SOULIOTES, ALEXANDROS, APOSTOLOS3 | PO BOX 1536 SOLANA BEACH, CA 92075 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $23K | $2K | $26K | 35.07% |
| HARTMAN, ZACHARY3 | 5355 E HIGH ST., STE. 201 PHOENIX, AZ 85054 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $18K | $2K | $19K | 26.30% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 9375 GREENSBORO, NC 27429 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $18K | — | $18K | 23.99% |
| MARSH & MCLENNAN AGENCY LLC3 | 2300 RENAISSANCE BLVD. KING OF PRUSSIA, PA 19406 | DELTA DENTAL OF NORTH CAROLINA | $4K | — | $4K | 6.02% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 SO. 8TH ST., STE. 700 MINNEAPOLIS, MN 55402 | DELTA DENTAL OF NORTH CAROLINA | $2K | — | $2K | 2.98% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 9375 GREENSBORO, NC 274290375 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $2K | $7K | 20.68% |
| SOULIOTES, ALEXANDROS, APOSTOLOS3 | PO BOX 1536 SOLANA BEACH, CA 92075 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | $378 | $9K | 28.64% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 9375 GREENSBORO, NC 27429 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $569 | $7K | 22.39% |
| HARTMAN, ZACHARY3 | 5355 E. HIGH ST., STE. 201 PHOENIX, AZ 85054 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $285 | $7K | 21.49% |
| GBS BENEFITS INC3 | 465 S. 400 E., STE. 300 SALT LAKE CITY, UT 84111 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 8.38% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 9395 GREENSBORO, NC 27429 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $1K | — | $1K | 5.57% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 SO. 8TH ST., STE. 700 MINNEAPOLIS, MN 55402 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $823 | — | $823 | 4.25% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 9375 GREENSBORO, NC 274290375 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $995 | $4K | 24.21% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 SO. 8TH ST., STE. 700 MINNEAPOLIS, MN 55402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $662 | — | $662 | 13.00% |
| MARSH & MCLENNAN AGENCY LLC3 | 3625 N. ELM ST. GREENSBORO, NC 274290375 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $357 | — | $357 | 7.01% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 SO. 8TH ST., STE. 700 MINNEAPOLIS, MN 55402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $513 | — | $513 | 15.08% |
| MARSH & MCLENNAN AGENCY LLC3 | 3625 N. ELM ST. GREENSBORO, NC 274290375 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $167 | — | $167 | 4.91% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 SO. 8TH ST., STE. 700 MINNEAPOLIS, MN 55402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $173 | — | $173 | 6.48% |
| MARSH & MCLENNAN AGENCY LLC3 | 3625 N. ELM ST. GREENSBORO, NC 274290375 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $94 | — | $94 | 3.52% |
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 | 162 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 162 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 160 | $32K |
| Dental | DELTA DENTAL OF NORTH CAROLINA | 248 | $63K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 224 | $19K |
| Life insurance(5 contracts, 3 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 324 | $148K |
| Short-term disability(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 227 | $77K |
| Long-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 224 | $37K |
| Other(5 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 324 | $106K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 324 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.