| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INSYNC BENEFITS INC3 Filed as: INSYNC BENEFITS | PO BOX 1474 CORNELIUS, NC 28031 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $964 | $5K | 7.44% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 6100 FAIRVIEW ROAD CHARLOTTE, NC 28210 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 2.68% |
| PATRICIA L CARON3 Filed as: PATRICIA L. CARON | 190 TESUQUE VILLAGE ROAD SANTA FE, NM 87506 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $853 | $130 | $983 | 1.55% |
| SUSAN FONTENOT3 | 10717 DAPPLE GREY LANE CHARLOTTE, NC 28213 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $810 | $30 | $840 | 1.32% |
| NANCY BAUCOM3 | 940-12 JETTON STREET DAVIDSON, NC 28036 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $528 | $58 | $586 | 0.92% |
| KJELL T TERRELL3 Filed as: KJELL T. TERRELL | 327 GOLF COURSE DRIVE RALEIGH, NC 27610 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $198 | — | $198 | 0.31% |
| MJ INSURANCE3 Filed as: ARTHUR JORDAN AND VARIOUS AGENTS | 514 OAKWOOD AVENUE RALEIGH, NC 28036 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $50 | — | $50 | 0.08% |
| SUZANNE K. JOHNSON3 | 5955 CARNEGIE BOULEVARD, SUITE 150 CHARLOTTE, NC 28209 | NORTHWESTERN MUTUAL | $1K | $371 | $2K | 8.08% |
| JENNIE D. DERBY3 | 6235 MORRISON BOULEVARD CHARLOTTE, NC 28211 | NORTHWESTERN MUTUAL | $1K | $336 | $2K | 7.93% |
| RICHARD WORRELL LLC3 | 6235 MORRISON BOULEVARD CHARLOTTE, NC 28211 | NORTHWESTERN MUTUAL | $646 | $57 | $703 | 3.11% |
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 | 521 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 526 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | COMMUNITY EYE CARE | 546 | $65K |
| Life insurance | AETNA LIFE INSURANCE COMPANY | 521 | $314K |
| Short-term disability(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 521 | $378K |
| Long-term disability(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 521 | $337K |
| Other(3 contracts, 3 carriers) | AETNA LIFE INSURANCE COMPANY | 521 | $382K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 546 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.