| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MELISSA MURBACH3 Filed as: MELISSA E MURBACH | 1105 LAUREL AVE KING, NC 27021 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3K | — | $3K | 3.58% |
| KELLY LEBSACK3 Filed as: KELLY D LEBSACK | 3300 BATTLEGROUND AVE. #206 GREENSBORO, NC 27410 | CONTINENTAL AMERICAN INSURANCE COMPANY | $545 | — | $545 | 0.60% |
| LORI A WILLIAMS3 | 45 OXFORD DRIVE MARTINSVILLE, VA 24112 | CONTINENTAL AMERICAN INSURANCE COMPANY | $213 | — | $213 | 0.23% |
| KATHERINE L SIMOS3 | 3309 CLARICE AVE PFAFFTOWN, NC 27040 | CONTINENTAL AMERICAN INSURANCE COMPANY | $192 | — | $192 | 0.21% |
| MIKE BUTLER3 | 1090 13TH AVE NW HICKORY, NC 28601 | CONTINENTAL AMERICAN INSURANCE COMPANY | $164 | — | $164 | 0.18% |
| JAMES R HILL JR3 Filed as: JAMES R HILL JR. | 7021 MARSEILLES CT SUMMERFIELD, NC 27358 | CONTINENTAL AMERICAN INSURANCE COMPANY | $125 | — | $125 | 0.14% |
| GREGORY E MEYER3 | 1582 RUNNING DEER DR KERNERSVILLE, NC 27284 | CONTINENTAL AMERICAN INSURANCE COMPANY | $121 | — | $121 | 0.13% |
| TREVOR G MURBACH3 | 1105 LAUREL BLUFF DR KING, NC 27021 | CONTINENTAL AMERICAN INSURANCE COMPANY | $81 | — | $81 | 0.09% |
| DIANA A TATE3 | 701 SIMPSONS ST GREENSBORO, NC 27401 | CONTINENTAL AMERICAN INSURANCE COMPANY | $63 | — | $63 | 0.07% |
| TRACI BATTOEN3 | 4110 SOUTHPOINT BLVD RD JACKSONVILLE, FL 32216 | CONTINENTAL AMERICAN INSURANCE COMPANY | $58 | — | $58 | 0.06% |
| KATRINA D AIKEN3 | 3462 38TH ST DR NE HICKORY, NC 28601 | CONTINENTAL AMERICAN INSURANCE COMPANY | $56 | — | $56 | 0.06% |
| DEBORAH A WITHEY3 | 2155 6TH ST NE HICKORY, NC 28601 | CONTINENTAL AMERICAN INSURANCE COMPANY | $50 | — | $50 | 0.06% |
| MELANIE ZEBRON3 | 1101 CLYDE EDGERTON DRIVE KERNERSVILLE, NC 27284 | CONTINENTAL AMERICAN INSURANCE COMPANY | $44 | — | $44 | 0.05% |
| JEREMY M HASKELL3 Filed as: JEREMY HASKELL | 2150 COUNTRY CLUB ROAD, STE 228 WINSTON-SALEM, NC 27104 | CONTINENTAL AMERICAN INSURANCE COMPANY | $29 | — | $29 | 0.03% |
| FRANKLIN TRAVIS BLACK3 Filed as: FRANKLIN BLACK | 5981 WOODFIELD DRIVE KERNERSVILLE, NC 27284 | CONTINENTAL AMERICAN INSURANCE COMPANY | $27 | — | $27 | 0.03% |
| FRANKLIN TRAVIS BLACK3 Filed as: FRANKLIN BLACK | 5981 WOODFIELD DRIVE KERNERSVILLE, NC 27284 | CONTINENTAL AMERICAN INSURANCE COMPANY | $20 | — | $20 | 0.02% |
| MEGHAN MOFFATT LUCAS3 Filed as: MEGHAN M MILLER | 6631 FOX RIDGE CIRCLE DAVIDSON, NC 28036 | CONTINENTAL AMERICAN INSURANCE COMPANY | $10 | — | $10 | 0.01% |
| ELIZABETH CUSHING3 | 9 WATER GARDEN WAY DURHAM, NC 27713 | CONTINENTAL AMERICAN INSURANCE COMPANY | $10 | — | $10 | 0.01% |
| ROBERT LYNN ASHLEY3 | 311 FALLS DRIVE ABINGDON, VA 24210 | AMERICAN HERITAGE LIFE INSURANCE | $274 | — | $274 | 1.34% |
| WILLIAM E CAMPBELL3 | 512 STRALEY AVE PRINCETON, WV 24740 | AMERICAN HERITAGE LIFE INSURANCE | $100 | — | $100 | 0.49% |
| DOROTHY C WALLER3 | 640 8TH STREET NE PULASKI, VA 24301 | AMERICAN HERITAGE LIFE INSURANCE | $42 | — | $42 | 0.20% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTHGRAM, INC. EIN 56-1449504 | Plan Administrator Service code 14 | — | $238K |
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 | 547 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 25 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 572 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | HM LIFE INSURANCE COMPANY | 383 | $983K |
| Other(2 contracts, 2 carriers) | CONTINENTAL AMERICAN INSURANCE COMPANY | 304 | $111K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 383 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.