| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 4064 COLONY ROAD, SUITE 450 CHARLOTTE, NC 28211 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $189K | — | $189K | 3.12% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 21ST FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $51K | — | $51K | 11.19% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $12K | $12K | 2.51% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4064 COLONY ROAD, SUITE 450 CHARLOTTE, NC 28211 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $11K | — | $11K | 2.96% |
| DAVID STORY3 Filed as: DAVID L STORY AND OTHER AGENTS | 707 MEADOW LANE KINGSPORT, TN 37663 | AFLAC | $10K | $195 | $10K | 8.61% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4064 COLONY ROAD, SUITE 450 CHARLOTTE, NC 28211 | AFLAC | $3K | — | $3K | 2.19% |
| AMY F KLUTTZ3 Filed as: AMY F KLUTZ | 2581 ESSEX DRIVE CONCORD, NC 28025 | AFLAC | $2K | $178 | $2K | 1.94% |
| DIANNE J RAY3 | PO BOX 335 SUNNY SIDE, GA 30284 | AFLAC | $1K | $152 | $1K | 1.23% |
| MARK C. HUBER3 Filed as: MARK C HUBER | 480 SAN GABRIEL DRIVE SONOMA, CA 95476 | AFLAC | $1K | — | $1K | 1.09% |
| DAVID C. HEALEY3 Filed as: DAVID C HEALEY | FOUR SUFFOLK COURT BEDFORD, NH 03110 | AFLAC | $928 | $18 | $946 | 0.82% |
| KELI RICHMOND3 | 230 BART GREEN DRIVE JOHNSON CITY, TN 37615 | AFLAC | $809 | — | $809 | 0.70% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4064 COLONY ROAD, SUITE 450 CHARLOTTE, NC 28211 | VISION SERVICE PLAN | $2K | — | $2K | 3.02% |
| CAROLINA BENEFITS SOURCE INC3 Filed as: CAROLINA BENEFITS SOURCE | 4461 NE 30TH AVENUE LIGHTHOUSE POINT, FL 33064 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $423 | — | $423 | 2.30% |
| EDWIN C. THORNE3 | 11523 CHESTNUT HILL DRIVE MATTHEWS, NC 28105 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $343 | — | $343 | 1.86% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES, INC. | 4064 COLONY ROAD CHARLOTTE, NC 28211 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $270 | — | $270 | 1.47% |
| ROBERT P MCFARLAND3 Filed as: ROBERT P. MCFARLAND | 6739 MOUNTAIN MAJESTY WAY HUNTERSVILLE, NC 28078 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $161 | — | $161 | 0.87% |
| LAURIE J BURNS3 Filed as: LAURIE J. BURNS | 303 PYLER ROAD INDIAN TRAIL, NC 28079 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $154 | — | $154 | 0.84% |
| THE PLANNING GROUP AND OTHER AGENTS3 | PO BOX 8334 WILSON, NC 27893 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $142 | — | $142 | 0.77% |
| INSYNC BENEFITS INC3 | PO BOX 1474 CORNEIUS, NC 28031 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $75 | — | $75 | 0.41% |
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 | 786 | 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) | 786 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 1,011 | $6.1M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 535 | $369K |
| Vision | VISION SERVICE PLAN | 476 | $73K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 824 | $462K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 824 | $460K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 824 | $460K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 1,011 | $6.1M |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 824 | $593K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,011 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.