| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 1 WEST 4TH STREET WINSTON SALEM, NC 27101 | RELIASTAR LIFE INSURANCE COMPANY | $110K | $14K | $124K | 16.76% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP SERVICES, LLC | PO BOX 2291 DURNHAM, NC 27702 | RELIASTAR LIFE INSURANCE COMPANY | $0 | $37K | $37K | 4.94% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 1 WEST 4TH STREET WINSON SALEM, NC 27101 | DELTA DENTAL OF NORTH CAROLINA | $61K | $0 | $61K | 11.94% |
| MARION BAXTER JR3 | PO BOX 642 TABOR CITY, NC 28463 | AFLAC | $12K | $670 | $13K | 11.11% |
| MARTIN D ADAMS3 Filed as: MARTIN ADAMS | PO BOX 1927 CLINTON, NC 28329 | AFLAC | $3K | $116 | $3K | 2.85% |
| MJ INSURANCE3 Filed as: RODERICK WHITFORD & VARIOUS AGENTS | 1417 HAWTHORNE ROAD WILMINGTON, NC 28403 | AFLAC | $2K | $0 | $2K | 1.77% |
| JOEL S WADDELL3 Filed as: JOEL WADDELL | 354 NC 581 HIGHWAY SOUTH GOLDSBORO, NC 27530 | AFLAC | $1K | $101 | $1K | 1.25% |
| MAURICE WATSON3 | 408 WALKING STICK TRAIL CLINTON, NC 28328 | AFLAC | $1K | $0 | $1K | 1.05% |
| THOMAS E HATCHER JR3 Filed as: THOMAS HATCHER JR | 1588 BAYTREE DRIVE HARRELLS, NC 28444 | AFLAC | $269 | $0 | $269 | 0.23% |
| DANIEL DUNNE III3 | 3421 DIXIANA LANE PFAFFTOWN, NC 27040 | AFLAC | $234 | $0 | $234 | 0.20% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 1 WEST 4TH STREET WINSTON SALEM, NC 27101 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $10K | $0 | $10K | 10.00% |
| SHEILA B. BAXTER3 Filed as: SHEILA B BAXTER | PO BOX 642 TABOR CITY, NC 28463 | CONTINENTAL AMERICAN INSURANCE COMPANY | $937 | $0 | $937 | 2.93% |
| MAURICE WATSON3 Filed as: MAURICE R WATSON | 408 WALKING STICK TRAIL CLINTON, NC 28328 | CONTINENTAL AMERICAN INSURANCE COMPANY | $873 | $0 | $873 | 2.73% |
| MARTIN D ADAMS3 | PO BOX 1927 CLINTON, NC 28329 | CONTINENTAL AMERICAN INSURANCE COMPANY | $433 | $0 | $433 | 1.35% |
| JILL R LAMBERT3 Filed as: JILL W DENTON | 3500 WESTGATE DRIVE SUITE 602 DURHAM, NC 27707 | CONTINENTAL AMERICAN INSURANCE COMPANY | $259 | $0 | $259 | 0.81% |
| LARRY A WESTON JR3 Filed as: LARRY A WESTON, JR. | 209 BRISTOL COURT GREENVILLE, NC 27834 | CONTINENTAL AMERICAN INSURANCE COMPANY | $212 | $0 | $212 | 0.66% |
| MJ INSURANCE3 Filed as: JOEL WADDELL AND VARIOUS AGENTS | 354 NC HIGHWAY 581 SOUTH GOLDSBORO, NC 27530 | CONTINENTAL AMERICAN INSURANCE COMPANY | $49 | $0 | $49 | 0.15% |
| GORDON K VANN3 | 2156 WESLEY LANE GREENVILLE, NC 27858 | CONTINENTAL AMERICAN INSURANCE COMPANY | $27 | $0 | $27 | 0.08% |
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 | 784 | 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) | 784 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF NORTH CAROLINA | 1,479 | $513K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 1,312 | $97K |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 2,017 | $740K |
| Short-term disability | RELIASTAR LIFE INSURANCE COMPANY | 2,017 | $740K |
| Long-term disability | RELIASTAR LIFE INSURANCE COMPANY | 2,017 | $740K |
| Other(3 contracts, 3 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 2,017 | $888K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,017 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.