| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 8049 CORPORATE CENTER DRIVE CHARLOTTE, NC 28226 | BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA | $79K | $0 | $79K | 2.99% |
| USI INSURANCE SERVICES LLC3 | 312 ELM STREET, 24TH FLOOR CINCINNATI, OH 45202 | AETNA LIFE INSURANCE COMPANY | $23K | $0 | $23K | 6.06% |
| USI INSURANCE SERVICES LLC3 | 8049 CORPORATE CENTER DRIVE CHARLOTTE, NC 28226 | VISION SERVICE PLAN | $2K | $0 | $2K | 4.28% |
| BENEFITS COUNT INC3 Filed as: BENEFITS COUNT LL, INC. | 1401 CHRISTMAS COURT RALEIGH, NC 27604 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $1K | $3K | 10.08% |
| USI INSURANCE SERVICES LLC3 | 8049 CORPORATE CENTER DRIVE CHARLOTTE, NC 28226 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $129 | $3K | 9.50% |
| KJELL T TERRELL3 Filed as: KJELL T. TERRELL | 327 GOLF COURSE DRIVE RALEIGH, NC 27610 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $230 | $1K | 3.84% |
| ARTHUR WAYNE JORDAN JR3 Filed as: ARTHUR WAYNE JORDAN, JR. | 514 OAKWOOD AVENUE RALEIGH, NC 27601 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $658 | $257 | $915 | 2.76% |
| KRISTEN BIBLE3 | 5461 TRALEE PLACE RALEIGH, NC 27609 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $606 | $64 | $670 | 2.02% |
| SUSAN FONTENOT3 Filed as: SUSAN FONTENOT AND OTHER AGENTS | 10717 DAPPLE GREY LANE CHARLOTTE, NC 28213 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $201 | $11 | $212 | 0.64% |
| ADVANCED ENROLLMENT SERVICES INC3 Filed as: ADVANCED ENROLLMENT SERVICES, INC. | 309 IRONWOODS DRIVE CHAPEL HILL, NC 27516 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $86 | $5 | $91 | 0.27% |
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 | 209 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 215 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA | 187 | $2.6M |
| Dental | AETNA LIFE INSURANCE COMPANY | 548 | $381K |
| Vision | VISION SERVICE PLAN | 245 | $36K |
| Life insurance | AETNA LIFE INSURANCE COMPANY | 548 | $381K |
| Short-term disability | AETNA LIFE INSURANCE COMPANY | 548 | $381K |
| Long-term disability | AETNA LIFE INSURANCE COMPANY | 548 | $381K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA | 187 | $2.6M |
| Other(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 548 | $414K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 548 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.