| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CHARLES R BALLOU Filed as: CHARLES BALLOU | PO BOX 473 JEFFERSON, NC 28640 | AFLAC | $7K | $237 | $7K | — |
| AMY D BALLOU Filed as: AMY BALLOU | PO BOX 473 JEFFERSON, NC 28640 | AFLAC | $3K | $76 | $3K | — |
| JOHN THOMAS | PPO BOX 1195 TAYLORSVILLE, NC 28681 | AFLAC | $3K | $0 | $3K | — |
| LISA L RANDOLPH Filed as: LISA RANDOLPH | PO BOX 1890 WEST JEFFERSON, NC 28694 | AFLAC | $2K | $185 | $3K | — |
| TERESA L SELLS Filed as: TERESA SELLS | PO BOX 84 WEST JEFFERSON, NC 28694 | AFLAC | $2K | $93 | $3K | — |
| D AND V BUTLER INC Filed as: J BUTLER | 1440 OLD LENOIR RD. STE A HICKORY, NC 28601 | AFLAC | $494 | $0 | $494 | — |
| VICKI J MINCEY Filed as: VICKI MINCEY | PO BOX 1845 WEST JEFFERSON, NC 28694 | AFLAC | $406 | $37 | $443 | — |
| GWEN BUTLER | 1090 13TH AVE NW HICKORY, NC 28601 | AFLAC | $394 | $0 | $394 | — |
| D AND V BUTLER INC | 601 CRESCENT BL D STE 102 RIDGELAND, MS 39157 | AFLAC | $252 | $0 | $252 | — |
| KIMBERLY H SCHUSLER Filed as: KIMBERLY SCHUSLER | 249 CRESSY RD BRADFORD, NH 03221 | AFLAC | $249 | $0 | $249 | — |
| C KING | 931 S MAIN ST STE B #206 KERNERSVILLE, NC 27284 | AFLAC | $233 | $0 | $233 | — |
| ROGER L BLEVINS Filed as: ROGER BLEVINS | PO BOX 458 JEFFERSON, NC 28640 | AFLAC | $229 | $0 | $229 | — |
| BROWN AND BROWN OF FLORIDA, INC. Filed as: JOHN BROWN | PO BOX 501 JEFFERSON, NC 28640 | AFLAC | $193 | $0 | $193 | — |
| GARRY D GOBLE Filed as: GARRY GOBLE | PO BOX 1664 TAYLORSVILLE, NC 28681 | AFLAC | $175 | $0 | $175 | — |
| BRIAN S MARTIN Filed as: BRIAN MARTIN | 115 HICKORY POINT CT STATESVILLE, NC 28677 | AFLAC | $168 | $0 | $168 | — |
| LOWELL K YOUNCE Filed as: LOWELL YOUNCE | PO BOX 130 ZIONVILLE, NC 28698 | AFLAC | $160 | $0 | $160 | — |
| TENA C DAVIS Filed as: TENA DAVIS | PO BOX 1135 LENOIR, NC 28645 | AFLAC | $150 | $0 | $150 | — |
| RICHARD SMITHSON | 449 TIMBER PL MILTON, GA 30004 | AFLAC | $141 | $0 | $141 | — |
| KATRINA D AIKEN Filed as: KATRINA AIKEN | 2511 JUDITH ST LYNCHBURG, VA 24501 | AFLAC | $125 | $0 | $125 | — |
| STEPHEN E CANIPE Filed as: STEPHEN CANIPE | 1177 WATERFORD DR. HICKORY, NC 28602 | AFLAC | $98 | $0 | $98 | — |
| DONNA S SPROUSE Filed as: DONNA SPROUSE | PO BOX 11022 HICKORY, NC 28603 | AFLAC | $98 | $0 | $98 | — |
| RETTA S RICE Filed as: RETTA RICE | 1001 4TH CREEK LANDING DR STATESVILLE, NC 28625 | AFLAC | $96 | $0 | $96 | — |
| MATTHEW PINER | 100 S SMITHFIELD RD KNIGHTDALE, NC 27545 | AFLAC | $78 | $0 | $78 | — |
| FLORINDA S HARWOOD Filed as: FLORINDA HARWOOD | PO BOX 1133 TAYLORSVILLE, NC 28681 | AFLAC | $77 | $0 | $77 | — |
| WILLIAM L BAKER IV Filed as: WILLIAM BAKER IV | 2310 S MIAMI BLVD STE 239 DURHAM, NC 27703 | AFLAC | $64 | $0 | $64 | — |
| AF INSURANCE SERVICES INC | PO BOX 825 WEST JEFFERSON, NC 28694 | AFLAC | $62 | $0 | $62 | — |
| RICKY D BUMGARNER Filed as: RICKY BUMGARNER | PO BOX 882 TAYLORSVILLE, NC 28681 | AFLAC | $62 | $0 | $62 | — |
| MATTHEW D BUTLER Filed as: MATTHEW BUTLER | 123 CENTER PARK DR STE 102 KNOXVILLE, TN 37922 | AFLAC | $40 | $0 | $40 | — |
| BROWN AND BROWN OF FLORIDA, INC. Filed as: KATHY BROWN | O BOX 694 JEFFERSON, NC 28640 | AFLAC | $38 | $0 | $38 | — |
| EXCEPTIONAL SERVICES INC | 158 PRINTERS LN NEW LONDON, NC 28127 | AFLAC | $27 | $0 | $27 | — |
| GORIA KRISS | 913 42ND AVE LN NE HICKORY, NC 28601 | AFLAC | $27 | $0 | $27 | — |
| TERRY SILVERS | 100 GREENLEAF DR FLAT ROCK, NC 28731 | AFLAC | $17 | $0 | $17 | — |
| DAVID MORGAN | 906 MERCHANT LEE PL MANAKIN SABOT, VA 23103 | AFLAC | $17 | $0 | $17 | — |
| NICHOLAS SAUNDERS | 59 LYNWOOD CIR ASHEVILLE, NC 28806 | AFLAC | $16 | $0 | $16 | — |
| TONY J DELBEN Filed as: TONY DELBEN | 143 SANDREED DR MOORESVILLE, NC 28117 | AFLAC | $13 | $0 | $13 | — |
| SUSAN E HENSON Filed as: SUSAN HENSON | PO BOX 298 VILAS, NC 28692 | AFLAC | $11 | $0 | $11 | — |
| DEBORAH A WITHEY Filed as: DEBORAH WITHEY | 2149 6TH ST NW HICKORY, NC 28601 | AFLAC | $11 | $0 | $11 | — |
| JUDY SAINE | 3564 SECTIONHOUSE RD HICKORY, NC 28601 | AFLAC | $10 | $0 | $10 | — |
| REBECCA MORGAN | 154 13TH AVE NW HICKORY, NC 28601 | AFLAC | $9 | $0 | $9 | — |
| JEFFREY PAUL SEPESI Filed as: JEFFREY SEPESI | 158 PRINTERS LN NEW LONDON, NC 28127 | AFLAC | $5 | $0 | $5 | — |
| ANN LITTON | 116 ALBERTVILLE LN SHELBY, NC 28152 | AFLAC | $4 | $0 | $4 | — |
| JULIE W CRAIG Filed as: JULIE CRAIG | 10722 NW 20TH DR CORAL SPRINGS, FL 33071 | AFLAC | $3 | $0 | $3 | — |
| DENA JORDAN | 641 HIGUERA ST STE 300 SAN LUIS OBISPO, CA 93401 | AFLAC | $3 | $0 | $3 | — |
| RONALD MOSTO II | 6610 HARVEST DR. PAPILLION, NE 68133 | AFLAC | $2 | $0 | $2 | — |
| ERIC MILLER | 6631 FOX RIDGE CIRCLE DAVIDSON, NC 28036 | AFLAC | $1 | $0 | $1 | — |
| MEGHAN MILLER | 6631 FOX RIDGE CIRCLE DAVIDSON, NC 28036 | AFLAC | $1 | $0 | $1 | — |
| STEPHEN C SIBEL Filed as: STEPHEN SIBEL | 86 MAPLE AVE COLLEGEVILLE, PA 19426 | AFLAC | $0 | $0 | $0 | — |
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 | 157 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 157 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AFLAC | 157 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 157 | — |
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.