| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MELISSA MURBACH3 Filed as: MELISSA E MURBACH | 1105 LAUREL BLUFF DRIVE KING, NC 27021 | CONTINENTAL AMERICAN INSURANCE COMPANY | $11K | — | $11K | 8.97% |
| GREENPOINT INSURANCE GROUP INC3 | 711 GALLIMORE DAIRY ROAD HIGH POINT, NC 27265 | CONTINENTAL AMERICAN INSURANCE COMPANY | $10K | — | $10K | 8.20% |
| KELLY LEBSACK3 Filed as: KELLY D LEBSACK | 3300 BATTLEGROUND AVENUE SUITE 206 GREENSBORO, NC 27410 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3K | — | $3K | 2.20% |
| WORKSITE ASSOCIATES LLC3 | 2307 WEST CONE BOULEVARD SUITE 110 GREENSBORO, NC 27408 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | — | $2K | 1.72% |
| LORI A WILLIAMS3 | 45 OXFORD DRIVE MARTINSVILLE, VA 24112 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | — | $2K | 1.39% |
| LINKEDAGENCY LLC3 | 9820 NORTHCROSS CENTER HUNTERSVILLE, NC 28078 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 1.15% |
| MIKE BUTLER3 | 1440-A OLD LENOIR ROAD NW HICKORY, NC 28601 | CONTINENTAL AMERICAN INSURANCE COMPANY | $961 | — | $961 | 0.77% |
| DIANA A TATE3 | 701 SIMPSONS STREET GREENSBORO, NC 27401 | CONTINENTAL AMERICAN INSURANCE COMPANY | $919 | — | $919 | 0.73% |
| TREVOR G MURBACH3 | 1105 LAUREL BLUFF DRIVE KING, NC 27021 | CONTINENTAL AMERICAN INSURANCE COMPANY | $604 | — | $604 | 0.48% |
| MELANIE ZEBRON3 | 1101 CLYDE EDGERTON DRIVE KERNERSVILLE, NC 27284 | CONTINENTAL AMERICAN INSURANCE COMPANY | $432 | — | $432 | 0.35% |
| KATRINA D AIKEN3 | 3462 38TH ST DR NE HICKORY, NC 28601 | CONTINENTAL AMERICAN INSURANCE COMPANY | $405 | — | $405 | 0.32% |
| DEBORAH A WITHEY3 | 2155 6TH ST. NE HICKORY, NC 28601 | CONTINENTAL AMERICAN INSURANCE COMPANY | $365 | — | $365 | 0.29% |
| JAMES R HILL JR3 Filed as: JAMES R HILL, JR | 7021 MARSEILLES COURT SUMMERFIELD, NC 27358 | CONTINENTAL AMERICAN INSURANCE COMPANY | $251 | — | $251 | 0.20% |
| FRANKLIN TRAVIS BLACK3 | 5981 WOODFIELD DRIVE KERNERSVILLE, NC 27284 | CONTINENTAL AMERICAN INSURANCE COMPANY | $135 | — | $135 | 0.11% |
| FRANKLIN TRAVIS BLACK3 | 5981 WOODFIELD DR KENNERSVILLE, NC 27284 | CONTINENTAL AMERICAN INSURANCE COMPANY | $56 | — | $56 | 0.04% |
| MEGAN M MILLER3 | 6631 FOX RIDGE CIRCLE DAVIDSON, NC 28036 | CONTINENTAL AMERICAN INSURANCE COMPANY | $28 | — | $28 | 0.02% |
| ELIZABETH CUSHING3 | 9 WATER GARDEN WAY DURHAM, NC 27713 | CONTINENTAL AMERICAN INSURANCE COMPANY | $28 | — | $28 | 0.02% |
| KATHRYN H MORGAN3 | 1589 SKEET CLUB ROAD SUITE 102 BOX 132 HIGH POINT, NC 272658817 | CONTINENTAL AMERICAN INSURANCE COMPANY | $15 | — | $15 | 0.01% |
| ROBERT LYNN ASHLEY3 | 311 FALLS DRIVE ABINGDON, VA 24210 | AMERICAN HERITAGE LIFE INSURANCE | $3K | — | $3K | 11.25% |
| WILLIAM E CAMPBELL3 | 512 STRALEY AVENUE PRINCETON, WV 24740 | AMERICAN HERITAGE LIFE INSURANCE | $402 | — | $402 | 1.39% |
| ROBERT LYNN ASHLEY3 Filed as: ROBERT ASHLEY | PO BOX 722 ABINGDON, VA 242120722 | AMERICAN HERITAGE LIFE INSURANCE | $93 | — | $93 | 0.32% |
| DOROTHY C WALLER3 | 640 8TH STREET NE PULASKI, VA 24301 | AMERICAN HERITAGE LIFE INSURANCE | $69 | — | $69 | 0.24% |
| SOUTHERN SECURITY SPEC SVCS3 Filed as: SOUTHERN SECURITY SPEC SERV | 4813 COUGAR TRAIL RD DUBLIN, VA 24084 | AMERICAN HERITAGE LIFE INSURANCE | $66 | — | $66 | 0.23% |
| BOWLES ASSOC INC3 | PO BOX 700 FORK UNION, VA 23055 | AMERICAN HERITAGE LIFE INSURANCE | $22 | — | $22 | 0.08% |
| JAMES E. PERKINS3 Filed as: JAMES E PERKINS | 2205 LONG DRIVE ROCKVILLE, VA 23146 | AMERICAN HERITAGE LIFE INSURANCE | $13 | — | $13 | 0.04% |
| WILLIAM E. CAMPBELL, JR3 | 4813 COUGAR TRAIL RD DUBLIN, VA 24084 | AMERICAN HERITAGE LIFE INSURANCE | $7 | — | $7 | 0.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTHGRAM, INC. EIN 56-1449504 PROVIDER ADMIN | Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Claims processing; Float revenue; Contract Administrator Service code 12 | — | $179K |
| ALLIANCE PPO EIN 52-2129786 NETWORK MGMT | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $23K |
| GATEWAY PPO EIN 54-1756711 NETWORK MGMT | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $9K |
| MEDCOST EIN 22-2360010 NETWORK MGMT | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $1K |
| FIRST HEALTH PPO EIN 20-1736473 NETWORK MGMT | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $828 |
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 | 529 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 36 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 565 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AMERICAN HERITAGE LIFE INSURANCE | 47 | $29K |
| Life insurance | AMERICAN HERITAGE LIFE INSURANCE | 47 | $29K |
| Other | CONTINENTAL AMERICAN INSURANCE COMPANY | 248 | $125K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 248 | — |
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.