| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LIFESTORE INS SERVICES INC3 | PO BOX 825 WEST JEFFERSON, NC 28694 | COMPANION LIFE INSURANCE COMPANY | $9K | — | $9K | 9.99% |
| THE CASON GROUP INC3 | PO BOX 11229 COLUMBIA, SC 29211 | COMPANION LIFE INSURANCE COMPANY | $5K | — | $5K | 5.00% |
| LIFESTORE INS SERVICES INC3 | 206 S JEFFERSON AVE W JEFFERSON, NC 28694 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | — | $7K | 10.00% |
| VICKI J MINCEY3 | PO BOX 1845 WEST JEFFERSON, NC 28694 | AFLAC | $7K | $26 | $7K | 11.91% |
| TERESA L SELLS3 | PO BOX 84 WEST JEFFERSON, NC 28694 | AFLAC | $2K | $9 | $2K | 2.72% |
| LISA L RANDOLPH3 | PO BOX 1890 WEST JEFFERSON, NC 28694 | AFLAC | $1K | $9 | $1K | 2.32% |
| SUSAN HOOSIER3 Filed as: SUSAN R HOOSIER | 9385 NC HIGHWAY 88 W WARRENSVILLE, NC 28693 | AFLAC | $1K | $9 | $1K | 1.75% |
| NATASHA FAW3 | PO BOX 1448 WEST JEFFERSON, NC 28694 | AFLAC | $932 | — | $932 | 1.52% |
| DANIEL SEXTON3 | PO BOX 694 JEFFERSON, NC 28640 | AFLAC | $421 | — | $421 | 0.69% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: KATHY S BROWN | PO BOX 694 WEST JEFFERSON, NC 28640 | AFLAC | $150 | $5 | $155 | 0.25% |
| DANIEL SEXTON3 | 806 RUSTIC RD WEST JEFFERSON, NC 28694 | AFLAC | $151 | $3 | $154 | 0.25% |
| PENNY L AMBROSE3 | 531 GLENN BARE RD JEFFERSON, NC 28640 | AFLAC | $132 | — | $132 | 0.22% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: KATHY S BROWN | PO BOX 501 JEFFERSON, NC 28640 | AFLAC | $83 | — | $83 | 0.14% |
| LOWELL K YOUNCE3 | PO BOX 130 ZIONVILLE, NC 28698 | AFLAC | $69 | — | $69 | 0.11% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: JOHN H BROWN | PO BOX 501 JEFFERSON, NC 28640 | AFLAC | $46 | — | $46 | 0.07% |
| KATRINA D AIKEN3 | 2511 JUDITH ST LYNCHBURG, VA 24501 | AFLAC | $40 | — | $40 | 0.07% |
| DEBORAH A WITHEY3 | 2149 6TH ST NW HICKORY, NC 28601 | AFLAC | $39 | — | $39 | 0.06% |
| AMY D BALLOU3 | PO BOX 473 JEFFERSON, NC 28640 | AFLAC | $28 | — | $28 | 0.05% |
| RICHARD SMITHSON3 | 449 TIMBER PL MILTON, GA 30004 | AFLAC | $25 | — | $25 | 0.04% |
| REBECCA A JOHNSON3 | 206 OVERLOOK DR CRUMPLER, NC 28617 | AFLAC | $21 | — | $21 | 0.03% |
| DAVID L SAINE3 | 3564 SECTIONHOUSE RD HICKORY, NC 28601 | AFLAC | $21 | — | $21 | 0.03% |
| CINDY K CHILDERS3 | 88 STARMOUNT LN TAYLORSVILLE, NC 28681 | AFLAC | $21 | — | $21 | 0.03% |
| J MICHAEL BUTLER3 | 1440 OLD LENOIR RD SUITE A HICKORY, NC 28601 | AFLAC | $19 | — | $19 | 0.03% |
| C HARVEY KING3 | 931 S MAIN ST SUITE B #206 KERNERSVILLE, NC 27284 | AFLAC | $14 | — | $14 | 0.02% |
| GARRY D GOBLE3 | PO BOX 1664 TAYLORSVILLE, NC 28681 | AFLAC | $12 | — | $12 | 0.02% |
| GWEN NICHOLS BUTLER3 | 1090 13TH AVE NW HICKORY, NC 28601 | AFLAC | $9 | — | $9 | 0.01% |
| GLORIA K KRISS3 | 913 42ND AVE LN NE HICKORY, NC 28601 | AFLAC | $8 | — | $8 | 0.01% |
| JENNY J VOYSEY3 | 6120 CARDINAL DR NEW BERN, NC 28560 | AFLAC | $8 | — | $8 | 0.01% |
| EXSEPTIONAL SERVICES INC3 | 158 PRINTERS LN NEW LONDON, NC 28127 | AFLAC | $7 | — | $7 | 0.01% |
| NICHOLAS R SAUNDERS3 | 59 LYNWOOD CIR ASHEVILLE, NC 28806 | AFLAC | $7 | — | $7 | 0.01% |
| WILLIAM L BAKER IV3 | 2310 S MIAMI BLVD SUITE 239 DURHAM, NC 27703 | AFLAC | $5 | — | $5 | 0.01% |
| TONY J DELBEN3 | 143 SANDREED DR MOORESVILLE, NC 28117 | AFLAC | $4 | — | $4 | 0.01% |
| NICHOLAS R SAUNDERS3 | 7 PINE RIDGE DR WEAVERVILLE, NC 28787 | AFLAC | $2 | — | $2 | 0.00% |
| DENA JORDAN3 Filed as: DENA L JORDAN | 641 HIGUERA ST SUITE 300 SAN LUIS OBISPO, CA 93401 | AFLAC | $2 | — | $2 | 0.00% |
| JULIE W CRAIG3 | 5381 W HILLSBORO BLVD APT 108 COCONUT CREEK, FL 33073 | AFLAC | $2 | — | $2 | 0.00% |
| STEPHEN C SIBEL3 | 86 MAPLE AVE COLLEGEVILLE, PA 19426 | AFLAC | $1 | — | $1 | 0.00% |
| LIFESTORE INS SERVICES INC3 | 206 S JEFFERSON AVE W JEFFERSON, NC 28694 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | — | $6K | 10.00% |
| LIFESTORE INS SERVICES INC3 | 206 S JEFFERSON AVE W JEFFERSON, NC 28694 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 10.00% |
| LEON MARTIN3 | 1520 MARTIN STREET WINSTON SALEM, NC 27103 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $18 | $4K | 11.04% |
| BARBARA C. FAW3 Filed as: BARBARA C FAW | 507 HAMBY MOUNTAIN ROAD PURLEAR, NC 28665 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $876 | — | $876 | 2.63% |
| INSYNC BENEFITS INC3 | PO BOX 1474 CORNELIUS, NC 28031 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $512 | $162 | $674 | 2.02% |
| CARLA ANDERSON GOODWIN3 | 5354 RIVER RD LIBERTY GROVE R NORTH WILKESBORO, NC 28659 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $426 | — | $426 | 1.28% |
| EDWARD MAKEPEACE WILLIAMS3 Filed as: EDWARD WATKINS & ASSOC INC | 3214 CHARLES B ROOT WYND RALEIGH, NC 27612 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $404 | — | $404 | 1.21% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PARKWAY ATLANTA, GA 30339 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $193 | — | $193 | 0.58% |
| ROBERT P MCFARLAND3 | 111 NORTH PINE ISLAND DR PLANTATION, FL 33324 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $124 | — | $124 | 0.37% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: CHARLES W MARSH | 6155 CHAMBERLAIN PL WINSTON SALEM, NC 27103 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $23 | — | $23 | 0.07% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1900 WEST LOOP SOUTH HOUSTON, TX 77027 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | — | $13 | 0.04% |
| UN HUI SMITH3 | PO BOX 1722 DAVIDSON, NC 28036 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.03% |
| JESSIE R CAPLEY3 | 1716 STILLWATER DR COLUMBIA, SC 29212 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | — | $9 | 0.03% |
| DONNA N DWYER3 | 1540 WESTBROOK PLAZA DRIVE WINSTON SALEM, NC 27103 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $3 | $7 | 0.02% |
| SHERRON HOPPER3 | PO BOX 85206 LEXINGTON, SC 29073 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.02% |
| PHIL COLEMAN3 | 18908 RIVERWIND LN DAVIDSON, NC 28036 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.02% |
| ADVANCED BENEFIT SYSTEM INC3 | 245 SEVEN FARMS DRIVE DANIEL ISLAND, SC 29492 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.01% |
| ROBERT G DE MAILLY3 | 522 CLEARVIEW DR COLUMBIA, SC 29212 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.01% |
| LINDA P COLEMAN3 | 18908 RIVER WIND LANE DAVIDSON, NC 28036 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| LIFESTORE INS SERVICES INC3 | 206 S JEFFERSON AVE W JEFFERSON, NC 28694 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
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 | 197 | 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) | 197 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | COMPANION LIFE INSURANCE COMPANY | 155 | $93K |
| Vision | COMMUNITY EYE CARE | 279 | $27K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 197 | $92K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 121 | $60K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 123 | $48K |
| Other(4 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 197 | $187K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 279 | — |
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.