| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ERIC W. BLACK3 | 4064 COLONY ROAD, SUITE 450 CHARLOTTE, NC 28806 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $29K | $0 | $29K | 4.74% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4250 CONGRESS STREET, SUITE 200 CHARLOTTE, NC 28209 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $21K | $0 | $21K | 7.17% |
| SCOTT INSURANCE3 | 3519 PELHAM ROAD, SUITE 107 GREENVILLE, SC 29615 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $13K | $0 | $13K | 4.41% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4250 CONGRESS STREET CHARLOTTE, NC 28209 | UNION SECURITY INSURANCE COMPANY | $4K | $0 | $4K | 8.89% |
| JAMES A SCOTT & SON INC3 Filed as: JAMES A. SCOTT AND SON, INC. | 1301 OLD GRAVES MILL ROAD LYNCHBURG, VA 24502 | UNION SECURITY INSURANCE COMPANY | $3K | $0 | $3K | 6.12% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 615 EAST BRITTON ROAD OKLAHOMA CITY, OK 73114 | SUN LIFE ASSURANCE COMPANY OF CANADA | $2K | $0 | $2K | 6.21% |
| JAMES A SCOTT & SON INC3 Filed as: JAMES A. SCOTT AND SON, INC. | PO BOX 10489 LYNCHBURG, VA 24502 | SUN LIFE ASSURANCE COMPANY OF CANADA | $2K | $0 | $2K | 4.88% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4250 CONGRESS STREET, SUITE 200 CHARLOTTE, NC 28209 | HARTFORD LIFE AND ACCIDENT | $2K | $0 | $2K | 22.52% |
| JAMES A SCOTT & SON INC3 Filed as: JAMES A. SCOTT AND SON, INC. | PO BOX 603438 CHARLOTTE, NC 28260 | HARTFORD LIFE AND ACCIDENT | $1K | $0 | $1K | 18.70% |
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 | 117 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 121 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 175 | $900K |
| Dental(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 117 | $342K |
| Vision | UNION SECURITY INSURANCE COMPANY | 74 | $47K |
| Life insurance(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 117 | $331K |
| Short-term disability(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 117 | $331K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 100 | $35K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 175 | $604K |
| Other(3 contracts, 3 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 117 | $339K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 175 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.