| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLEGACY BENEFIT SOLUTIONS LLC3 | PO BOX 25172 WINSTON SALEM, NC 27114 | AMERITAS LIFE INSURANCE CORP | $17K | $2K | $18K | 10.98% |
| ALLEGACY BENEFIT SOLUTIONS LLC3 | PO BOX 25172 WINSTON SALEM, NC 27114 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $1K | $5K | 7.22% |
| ALLEGACY BENEFIT SOLUTIONS LLC3 | PO BOX 25172 WINSTON SALEM, NC 27114 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $551 | $6K | 12.08% |
| ALLEGACY BENEFIT SOLUTIONS LLC3 | PO BOX 25172 WINSTON SALEM, NC 27114 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $597 | $4K | 12.00% |
| CAROLINA BENEFITS SOURCE INC3 | 4461 NE 30TH AVE LIGHTHOUSE PT, FL 33064 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $51 | $3K | 14.49% |
| TIM JARRELL3 | 301 S. ELM ST GREENSBORO, NC 27401 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $724 | — | $724 | 3.30% |
| DAVID MASON DOKELL3 | 127 GREAT POINT DR MOORESVILLE, NC 28117 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $669 | $51 | $720 | 3.28% |
| ASCENSION INSURANCE AGENCY3 | 5821 FAIVIEW ROAD CHARLOTTE, NC 29209 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $649 | — | $649 | 2.96% |
| PETER MICHAEL FOLEY JR3 | 150 PAMLICO LN MOORESVILLE, NC 28117 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $501 | — | $501 | 2.28% |
| ALLEGACY BENEFIT SOLUTIONS LLC3 | PO BOX 25172 WINSTON SALEM, NC 27114 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $46 | — | $46 | 0.21% |
| WORKSITE BENEFIT SOLUTIONS INC3 | 301 N. MAIN ST. STE 1030 WINSTON SALEM, NC 27101 | TRANSAMERICA LIFE INSURANCE COMPANY | -$15 | — | -$15 | — |
| ALLEGACY BENEFIT SOLUTIONS LLC3 | 530 N TRADE 3RD FLOOR WINSTON SALEM, NC 27114 | TRANSAMERICA LIFE INSURANCE COMPANY | -$175 | — | -$175 | — |
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 | 285 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 285 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 367 | $1.9M |
| Dental | AMERITAS LIFE INSURANCE CORP | 484 | $168K |
| Vision | AMERITAS LIFE INSURANCE CORP | 484 | $168K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 285 | $79K |
| Short-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 285 | $124K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 285 | $49K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 367 | $1.9M |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 285 | $71K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 484 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.