| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LISA L. HAMLETT3 Filed as: LISA HAMLETT | 100 N. MAIN STREET WINSTON-SALEM, NC 27105 | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | $151K | — | $151K | 31.61% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | P.O. BOX 601478 CHARLOTTE, NC 28260 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $20K | — | $20K | 10.85% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | P.O. BOX 203066 DALLAS, TX 75320 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $4K | $4K | 2.07% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | P.O. BOX 601478 CHARLOTTE, NC 28260 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $13K | — | $13K | 16.03% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | P.O. BOX 203066 DALLAS, TX 75320 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $2K | $2K | 2.00% |
| WELLS FARGO INSURANCE SERVICES3 | P.O. BOX 203510 DALLAS, TX 753203510 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $7K | — | $7K | 13.28% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | P.O. BOX 601478 CHARLOTTE, NC 28260 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $20K | $20K | 86.11% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | P.O. BOX 203066 DALLAS, TX 75320 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $494 | $494 | 2.13% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| FLORES & ASSOCIATES EIN 56-1542307 CONTRACT ADMINISTRATOR | Other services; Contract Administrator Service code 13 | — | $16K |
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 | 773 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 781 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 1,206 | $477K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 742 | $51K |
| Life insurance | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 769 | $184K |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 611 | $80K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 1,206 | $477K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 1,206 | $477K |
| Other(2 contracts) | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 787 | $208K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,206 | — |
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.