| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HEALTHGRAM INC3 Filed as: HEALTHGRAM INC. | P.O. BOX 11088 CHARLOTTE, NC 282201088 | HM LIFE INSURANCE COMPANY | $0 | — | $0 | 0.00% |
| MELISSA MURBACH3 Filed as: MELISSA E MURBACH | 1105 LAUREL AVE KING, NC 27021 | CONTINENTAL AMERICAN INSURANCE COMPANY | $5K | — | $5K | 4.99% |
| KELLY LEBSACK3 Filed as: KELLY D LEBSACK | 3300 BATTLEGROUND AVE. #206 GREENSBORO, NC 27410 | CONTINENTAL AMERICAN INSURANCE COMPANY | $584 | — | $584 | 0.58% |
| GREENPOINT INSURANCE GROUP INC3 | 711 GALLIMORE DAIRY RD HIGH POINT, NC 27265 | CONTINENTAL AMERICAN INSURANCE COMPANY | $379 | — | $379 | 0.38% |
| TRACI R BATTEN3 Filed as: TRACI R PETERS | 4110 SOUTHPOINT BLVD RD JACKSONVILLE, FL 32216 | CONTINENTAL AMERICAN INSURANCE COMPANY | $312 | — | $312 | 0.31% |
| LORI A WILLIAMS3 | 45 OXFORD DRIVE MARTINSVILLE, VA 24112 | CONTINENTAL AMERICAN INSURANCE COMPANY | $228 | — | $228 | 0.23% |
| MIKE BUTLER3 | 1090 13TH AVE NW HICKORY, NC 28601 | CONTINENTAL AMERICAN INSURANCE COMPANY | $170 | — | $170 | 0.17% |
| JAMES R HILL JR3 Filed as: JAMES R HILL JR. | 7021 MARSEILLES CT SUMMERFIELD, NC 27358 | CONTINENTAL AMERICAN INSURANCE COMPANY | $138 | — | $138 | 0.14% |
| TREVOR G MURBACH3 | 1105 LAUREL BLUFF DR KING, NC 27021 | CONTINENTAL AMERICAN INSURANCE COMPANY | $81 | — | $81 | 0.08% |
| DIANA A TATE3 | 701 SIMPSONS ST GREENSBORO, NC 27401 | CONTINENTAL AMERICAN INSURANCE COMPANY | $66 | — | $66 | 0.07% |
| KATHERINE L SIMOS3 | 3309 CLARICE AVE PFAFFTOWN, NC 27040 | CONTINENTAL AMERICAN INSURANCE COMPANY | $64 | — | $64 | 0.06% |
| KATRINA D AIKEN3 | 3462 38TH ST DR NE HICKORY, NC 28601 | CONTINENTAL AMERICAN INSURANCE COMPANY | $58 | — | $58 | 0.06% |
| WORKSITE ASSOCIATES LLC3 | 2307 WEST CONE BOULEVARD SUITE 110 GREENSBORO, NC 27408 | CONTINENTAL AMERICAN INSURANCE COMPANY | $55 | — | $55 | 0.05% |
| DEBORAH A WITHEY3 | 2155 6TH ST NE HICKORY, NC 28601 | CONTINENTAL AMERICAN INSURANCE COMPANY | $52 | — | $52 | 0.05% |
| MELANIE ZEBRON3 | 1101 CLYDE EDGERTON DRIVE KERNERSVILLE, NC 27284 | CONTINENTAL AMERICAN INSURANCE COMPANY | $44 | — | $44 | 0.04% |
| GREGORY E MEYER3 | 1582 RUNNING DEER DR KERNESVILLE, NC 27284 | CONTINENTAL AMERICAN INSURANCE COMPANY | $40 | — | $40 | 0.04% |
| LINKEDAGENCY LLC3 | 9820 NORTH CROSS CENTER HUNTERSVILLE, NC 28078 | CONTINENTAL AMERICAN INSURANCE COMPANY | $37 | — | $37 | 0.04% |
| FRANKLIN TRAVIS BLACK3 Filed as: FRANKLIN BLACK | 5981 WOODFIELD DRIVE KERNERSVILLE, NC 27284 | CONTINENTAL AMERICAN INSURANCE COMPANY | $24 | — | $24 | 0.02% |
| FRANKLIN TRAVIS BLACK3 Filed as: FRANKLIN BLACK | 5981 WOODFIELD DRIVE KERNERSVILLE, NC 27284 | CONTINENTAL AMERICAN INSURANCE COMPANY | $21 | — | $21 | 0.02% |
| MEGHAN MOFFATT LUCAS3 Filed as: MEGHAN M MILLER | 6631 FOX RIDGE CIRCLE DAVIDSON, NC 28036 | CONTINENTAL AMERICAN INSURANCE COMPANY | $11 | — | $11 | 0.01% |
| ELIZABETH CUSHING3 | 9 WATER GARDEN WAY DURHAM, NC 27713 | CONTINENTAL AMERICAN INSURANCE COMPANY | $11 | — | $11 | 0.01% |
| ROBERT LYNN ASHLEY3 | 311 FALLS DRIVE ABINGDON, VA 24210 | AMERICAN HERITAGE LIFE INSURANCE | $291 | — | $291 | 1.18% |
| WILLIAM E CAMPBELL3 | 512 STRALEY AVE PRINCETON, WV 24740 | AMERICAN HERITAGE LIFE INSURANCE | $100 | — | $100 | 0.40% |
| ROBERT LYNN ASHLEY3 Filed as: ROBERT ASHLEY | P.O. BOX 722 ABINGDON, VA 242120722 | AMERICAN HERITAGE LIFE INSURANCE | $93 | — | $93 | 0.38% |
| DOROTHY C WALLER3 | 640 8TH STREET NE PULASKI, VA 24301 | AMERICAN HERITAGE LIFE INSURANCE | $69 | — | $69 | 0.28% |
| BOWLES ASSOC INC3 | P.O. BOX 700 FORK UNION, VA 23055 | AMERICAN HERITAGE LIFE INSURANCE | $8 | — | $8 | 0.03% |
| JAMES E. PERKINS3 Filed as: JAMES E PERKINS | 2205 LONG DRIVE ROCKVILLE, VA 23146 | AMERICAN HERITAGE LIFE INSURANCE | $5 | — | $5 | 0.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTHGRAM, INC. EIN 56-1449504 | Plan Administrator Service code 14 | — | $253K |
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 | 550 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 26 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 576 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AMERICAN HERITAGE LIFE INSURANCE | 78 | $25K |
| Life insurance | AMERICAN HERITAGE LIFE INSURANCE | 78 | $25K |
| Stop-loss / reinsurancereinsurance | HM LIFE INSURANCE COMPANY | 820 | $866K |
| Other | CONTINENTAL AMERICAN INSURANCE COMPANY | 286 | $100K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 820 | — |
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.