| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62819 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $26K | $9K | $35K | 11.34% |
| USI INSURANCE SERVICES LLC3 | 310 1ST STREET SW, SUITE 1250 ROANOKE, VA 24011 | PROVIDENT LIFE AND ACCIDIENT INSURANCE COMPANY | $729 | $0 | $729 | 2.20% |
| EMPLOYEE FAMILY PROTECTION INC3 Filed as: EMPLOYEE FAMILY PROTECTION, INC. | PO BOX 1237 CLASTONBURY, CT 06033 | PROVIDENT LIFE AND ACCIDIENT INSURANCE COMPANY | $250 | $0 | $250 | 0.75% |
| DARRELLE E. DAVIS AND ASSOC., INC.3 | PO BOX 1596 KERNERSVILLE, NC 27285 | PROVIDENT LIFE AND ACCIDIENT INSURANCE COMPANY | $62 | $0 | $62 | 0.19% |
| MICHAEL L COUSINS3 Filed as: MICHAEL LYNN COUSINS | PO BOX 327 GARNER, NC 27529 | PROVIDENT LIFE AND ACCIDIENT INSURANCE COMPANY | $33 | $0 | $33 | 0.10% |
| THE WORKSITE GROUP LLC3 Filed as: WORKSITE SERVICES, INC. | PO BOX 327 GARNER, NC 27529 | PROVIDENT LIFE AND ACCIDIENT INSURANCE COMPANY | $17 | $0 | $17 | 0.05% |
| RALPH E. WHITE3 | PO BOX 53067 FAYETTEVILLE, NC 28305 | PROVIDENT LIFE AND ACCIDIENT INSURANCE COMPANY | $0 | $2 | $2 | 0.01% |
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 | 108 | 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) | 108 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 108 | $343K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 108 | $309K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 108 | $309K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 108 | $309K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 108 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.