| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62689 VIRGINIA BEACH, VA 23466 | RELIASTAR LIFE INSURANCE COMPANY | $89K | $0 | $89K | 11.07% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP SERVICES, LLC | PO BOX 2291 DURHAM, NC 27702 | RELIASTAR LIFE INSURANCE COMPANY | $0 | $39K | $39K | 4.90% |
| USI INSURANCE SERVICES LLC3 | 1 WEST 4TH STREET WINSTON-SALEM, NC 27101 | RELIASTAR LIFE INSURANCE COMPANY | $29K | $0 | $29K | 3.64% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | PO BOX 203383 DALLAS, TX 75320 | RELIASTAR LIFE INSURANCE COMPANY | $0 | $16K | $16K | 1.95% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | 2975 REGENT BOULEVARD IRVING, TX 75063 | DELTA DENTAL OF NORTH CAROLINA | $64K | $0 | $64K | 12.03% |
| MARTIN D ADAMS3 Filed as: MARTIN D. ADAMS | PO BOX 1927 CLINTON, NC 28329 | CONTINENTAL AMERICAN INSURANCE COMPANY | $59K | $0 | $59K | 21.59% |
| MAURICE WATSON3 Filed as: MAURICE R. WATSON | 408 WALKING STICK TRAIL CLINTON, NC 28328 | CONTINENTAL AMERICAN INSURANCE COMPANY | $29K | $0 | $29K | 10.52% |
| SANDRA ADAMS3 | 335 SPRUNT DRIVE CLINTON, NC 28228 | CONTINENTAL AMERICAN INSURANCE COMPANY | $26K | $0 | $26K | 9.64% |
| PAULETTE WATSON3 Filed as: PAULETTE G. WATSON | 408 WALKING STICK TRAIL CLINTON, NC 28328 | CONTINENTAL AMERICAN INSURANCE COMPANY | $26K | $0 | $26K | 9.47% |
| THE DIAMOND AGENCY LLC3 Filed as: THE DIAMOND AGENCY | 1017 ASHES DRIVE, SUITE 106 WILMINGTON, NC 28405 | CONTINENTAL AMERICAN INSURANCE COMPANY | $15K | $0 | $15K | 5.39% |
| SHEILA B. BAXTER3 | PO BOX 642 TABOR CITY, NC 28463 | CONTINENTAL AMERICAN INSURANCE COMPANY | $578 | $0 | $578 | 0.21% |
| JILL W. DENTON AND OTHER AGENTS3 | 3500 WESTGATE DRIVE, SUITE 602 DURHAM, NC 27707 | CONTINENTAL AMERICAN INSURANCE COMPANY | $313 | $0 | $313 | 0.11% |
| USI INSURANCE SERVICES LLC3 | 100 NORTH MAIN STREET, SUITE 1510 WINSTON-SALEM, NC 27101 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $10K | $0 | $10K | 10.00% |
| SHEILA B. BAXTER3 | PO BOX 642 TABOR CITY, NC 28463 | AFLAC | $5K | $23 | $5K | 8.85% |
| MARTIN D ADAMS3 Filed as: MARTIN D. ADAMS | PO BOX 1927 CLINTON, NC 28329 | AFLAC | $1K | $5 | $1K | 2.42% |
| J MICHAEL BUTLER3 Filed as: J. MICHAEL BUTLER AND OTHER AGENTS | 1090 13TH AVENUE NW HICKORY, NC 28601 | AFLAC | $912 | $0 | $912 | 1.76% |
| MAURICE WATSON3 Filed as: MAURICE R. WATSON | 408 WALKING STICK TRAIL CLINTON, NC 28328 | AFLAC | $594 | $0 | $594 | 1.14% |
| JOEL S WADDELL3 Filed as: JOEL S. WADDELL | 354 NC 581 HIGHWAY SOUTH GOLDSBORO, NC 27530 | AFLAC | $316 | $5 | $321 | 0.62% |
| THOMAS E HATCHER JR3 Filed as: THOMAS E. HATCHER, JR. | 1588 BAY TREE DRIVE HARRELLS, NC 28444 | AFLAC | $204 | $0 | $204 | 0.39% |
| RODERICK WHITFORD3 | 1417 HAWTHORNE ROAD WILMINGTON, NC 28403 | AFLAC | $196 | $0 | $196 | 0.38% |
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 | 730 | 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) | 730 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF NORTH CAROLINA | 1,436 | $529K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 688 | $96K |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 1,899 | $800K |
| Short-term disability | RELIASTAR LIFE INSURANCE COMPANY | 1,899 | $800K |
| Long-term disability | RELIASTAR LIFE INSURANCE COMPANY | 1,899 | $800K |
| Other(3 contracts, 3 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 1,899 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,899 | — |
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.