| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LISA L. HAMLETT3 Filed as: LISA L HAMLETT | 100 N. MAIN STREET WINSTON-SALEM, NC 27105 | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | $120K | — | $120K | 23.88% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA INC | P.O. BOX 220748 CHARLOTTE, NC 28222 | HARTFORD LIFE AND ACCIDENT | $42K | — | $42K | 20.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA INC | 10 SOUTH WACKER DRIVE, FLOOR 17 CHICAGO, IL 60606 | HARTFORD LIFE AND ACCIDENT | — | $1K | $1K | 0.57% |
| WELLS FARGO INSURANCE SERVICES3 | P.O. BOX 203510 DALLAS, TX 753203510 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $8K | — | $8K | 11.80% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| FLORES & ASSOCIATES EIN 56-1542307 CONTRACT ADMINISTRATOR | Other services; Contract Administrator Service code 13 | — | $19K |
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 | 716 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 8 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 730 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 1,109 | $502K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 655 | $64K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 879 | $208K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 879 | $208K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 1,109 | $502K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 1,109 | $502K |
| Other | HARTFORD LIFE AND ACCIDENT | 879 | $208K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,109 | — |
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.