| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 3605 GLENWOOD AVENUE, SUITE 201 RALEIGH, NC 276123908 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | — | $9K | 10.00% |
| UNITED PRODUCERS GROUP LLC3 Filed as: UNITED PRODUCERS GROUP, LLC | 1439 STUART ENGALS BLVD UNIT 300 MT PLEASANT, SC 29464 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $5K | $5K | 5.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 300 SUMMERS STREET SUITE 650 CHARLESTON, WV 25301 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $644 | $644 | 0.71% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 3605 GLENWOOD AVENUE, SUITE 201 RALEIGH, NC 276123908 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 10.00% |
| UNITED PRODUCERS GROUP LLC3 Filed as: UNITED PRODUCERS GROUP, LLC | 1439 STUART ENGALS BLVD UNIT 300 MT PLEASANT, SC 29464 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 5.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 300 SUMMERS STREET SUITE 650 CHARLESTON, WV 25301 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 3.85% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 3605 GLENWOOD AVENUE, SUITE 201 RALEIGH, NC 276123908 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 10.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 300 SUMMERS STREET SUITE 650 CHARLESTON, WV 25301 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 6.18% |
| UNITED PRODUCERS GROUP LLC3 Filed as: UNITED PRODUCERS GROUP, LLC | 1439 STUART ENGALS BLVD UNIT 300 MT PLEASANT, SC 29464 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 5.00% |
| KAREN A. SIMPSON3 Filed as: KAREN A SIMPSON | 7745 CHAPEL CREEK DRIVE DENVER, NC 28037 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 3.85% |
| PETER MICHAEL FOLEY JR3 | 150 PAMPLICO LANE MOORESVILLE, NC 28117 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $117 | $1K | 3.20% |
| 3C HOLDINGS INC3 Filed as: 3C HOLDINGS INC. | 908 SYDNEY DRIVE CHARLOTTE, NC 28270 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 2.43% |
| FOUNDERS FINANCIAL GROUP LLC3 | 737 PLANTATION RD LANCASTER, SC 29720 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $442 | $125 | $567 | 1.32% |
| JOANNE K ROY3 | 5500 TURKEY OAK DRIVE MINT HILL, NC 28227 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $319 | $23 | $342 | 0.80% |
| CAROLINA BENEFITS SOURCE INC3 Filed as: CAROLINA BENEFITS SOURCE INC. | 4461 NE 30TH AVENUE LIGHTHOUSE PT, FL 33064 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $193 | — | $193 | 0.45% |
| ADVANCED BENEFIT SYSTEM INC3 Filed as: ADVANCED BENEFIT SYSTEM INC. | 145 RIVER LANDING DRIVE DANIEL ISLAND, SC 29492 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $50 | $53 | $103 | 0.24% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | PO BOX 896620 CHARLOTTE, NC 282896620 | COMMUNITY EYE CARE | $4K | — | $4K | 10.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 3605 GLENWOOD AVENUE, SUITE 201 RALEIGH, NC 27612 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 10.00% |
| UNITED PRODUCERS GROUP LLC3 Filed as: UNITED PRODUCERS GROUP, LLC | 1439 STUART ENGALS BLVD UNIT 300 MT PLEASANT, SC 29464 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 5.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 300 SUMMERS STREET SUITE 650 CHARLESTON, WV 25301 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $438 | $438 | 1.54% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 3605 GLENWOOD AVENUE, SUITE 201 RALEIGH, NC 276123908 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 15.00% |
| UNITED PRODUCERS GROUP LLC3 Filed as: UNITED PRODUCERS GROUP, LLC | 1439 STUART ENGALS BLVD UNIT 300 MT PLEASANT, SC 29464 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 5.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 300 SUMMERS STREET SUITE 650 CHARLESTON, WV 25301 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $295 | $295 | 1.46% |
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 | 149 | 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) | 149 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 31 | $43K |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 146 | $90K |
| Vision | COMMUNITY EYE CARE | 273 | $37K |
| Life insurance(3 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 151 | $91K |
| Short-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 148 | $86K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 102 | $52K |
| Other(3 contracts, 3 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 151 | $75K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 273 | — |
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.