| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE INC. | 26 CENTURY BLVD/JP MORGAN CHASE NASHVILLE, TN 372143685 | METROPOLITAN LIFE INSURANCE COMPANY | — | $16K | $16K | 1.18% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NORTH CAROLINA | PO BOX 31817 CHARLOTTE, NC 282311817 | METROPOLITAN LIFE INSURANCE COMPANY | — | $7K | $7K | 0.52% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST | 214 N TRYON STREET SUITE 2500 CHARLOTTE, NC 282022381 | METROPOLITAN LIFE INSURANCE COMPANY | — | $31 | $31 | 0.00% |
| MJ INSURANCE3 Filed as: VARIOUS AGENTS LIST ATTACHED | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $59K | $2K | $62K | 19.35% |
| D M BURRELL & ASSOCIATES INC.3 | PO BOX 203 WAYNESVILLE, NC 28786 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11K | — | $11K | 6.84% |
| KIMBERLY C. GALLARDO3 Filed as: KIMBERLY C GALLARDO | 224 BIG SPIDER ROAD SYLVA, NC 28779 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $34 | $3K | 1.77% |
| LYNN MARIE BARRY3 Filed as: LYNN M MCLEOD | 165 MCDOWELL ROAD MILLS RIVER, NC 28759 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $150 | $3K | 1.59% |
| ELIZABETH KOENIG3 | PO BOX 239 PISGAH FOREST, NC 28768 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $71 | $2K | 1.09% |
| SCOTT MATTHEW BOWLING3 | 145 LARCHMONT DRIVE HENDERSONVILLE, NC 28791 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $2 | $1K | 0.87% |
| TERI C. JENKINSON3 Filed as: TERI C JENKINSON | PO BOX 1943 SYLVA, NC 28779 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $17 | $1K | 0.80% |
| VANCE R. MOORE3 Filed as: VANCE R MOORE | 2003 BRASSTOWN ROAD CULLOWHEE, NC 28723 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $99 | — | $99 | 0.06% |
| DAVID UNDERWOOD3 | PO BOX 32694 CHARLOTTE, NC 28232 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $74 | — | $74 | 0.05% |
| USI INSURANCE SERVICES LLC3 | 8049 CORPORATE CENTER DRIVE CHARLOTTE, NC 28226 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $66 | — | $66 | 0.04% |
| PIERCE GROUP BENEFITS LLC3 | 4928 LINKSLAND DRIVE HOLLY SPRINGS, NC 27540 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $66 | — | $66 | 0.04% |
| CRYSTAL R GUPTON3 | 200 LAFORET DRIVE MORGANTON, NC 28655 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $38 | — | $38 | 0.02% |
| MELODIE M MCDANIEL3 | 181 SILVER BLUFF DRIVE CANTON, NC 28716 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $37 | — | $37 | 0.02% |
| GLENN ZIMMERMAN INC3 Filed as: GLENN PIERCE | 5300 TEN-TEN ROAD APEX, NC 27539 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $34 | — | $34 | 0.02% |
| MARSHA RUSSELL3 | 3182 CONSERVANCY LANE CHARLESTON, SC 29414 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.01% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: JONI BROWN | 403 N 1ST AVENUE MAIDEN, NC 28650 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.00% |
| REGENCY 21 INSURANCE AGENCY INC3 Filed as: REGENCY 21 INSURANCE AGENCY INC. | 4928 LINKSLAND DRIVE HOLLY SPRINGS, NC 27540 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.00% |
| LAKE VIEW CONSULTING INC.3 | 19002 HAMPTON WOODS COURT CORNELIUS, NC 28031 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.00% |
| KEENA S GEORGE3 | 6367 STARTOWN ROAD MAIDEN, NC 28650 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.00% |
| RICHARD E BERMAN3 | 5243 WOODRUN ON TILLERY MT GILEAD, NC 27306 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| JOHN R CHRISTIANSEN3 | 4 BRAXTON LANE THOMASVILLE, NC 27360 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| RAYMOND C AUSTIN3 | 1231 WEXFORD VILLAGE CIRCLE LENOIR, NC 28645 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| BENEFITS COUNT INC3 Filed as: BENEFITS COUNT INC. | 1401 CHRISTIMAS COURT RALEIGH, NC 27604 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $1 | $2 | 0.00% |
| MARK LINDSEY MURPHY3 | 1210 CLYDE AVENUE SILER CITY, NC 27344 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| RICHARD RAMEY3 Filed as: RICHARD THARRINGTON | 1053 BULLARD COURT RALEIGH, NC 27615 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| ROBERT WOODFIN3 | 2401 FRASERBURGH DRIVE MATTHEWS, NC 28105 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| MJ INSURANCE3 Filed as: VARIOUS AGENTS - SEE ATTACHMENT | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $3K | — | $3K | 48.50% |
| MJ INSURANCE3 Filed as: VARIOUS AGENTS - SEE ATTACHMENT | 1932 WYNTON ROAD COLUMBUS, GA 31999 | AFLAC | $2K | $157 | $2K | 29.39% |
| MJ INSURANCE3 Filed as: VARIOUS AGENTS - SEE ATTACHMENT | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $460 | $25 | $485 | 12.71% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD EIN 59-0894904 CLAIMS ADMINISTRATION | Claims processing Service code 12 | — | $1.1M |
| EMPLOYEE ASSISTANCE NETWORK EIN 20-5468358 EMPLOYEE ASSISTANCE PROG | Contract Administrator; Other fees Service code 13 | 417 BILTMORE AVENUE DOCTOR'S PARK SUITE 3-C ASHEVILLE, NC 28801 | $22K |
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 | 2,442 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 16 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,458 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 2,363 | $789K |
| Vision | COMMUNITY EYE CARE | 2,734 | $141K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 5,645 | $1.5M |
| Short-term disability(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 5,645 | $1.5M |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 5,645 | $1.3M |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 2,363 | $789K |
| Other(6 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 5,645 | $1.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,645 | — |
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."
No prospect flags tripped on this filing.