| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KAREN B MATHIS3 Filed as: KAREN MATHIS | 3730 BURLINGTON ROAD ROXBORO, NC 27574 | AFLAC | $57K | $3K | $60K | 13.30% |
| TODD SYKES3 | 1274 SILKY WILLOW DRIVE WAKE FOREST, NC 27587 | AFLAC | $8K | $539 | $8K | 1.86% |
| JENNIFER VANROEKEL3 | 37A BERNARD ROAD HAMPTON, VA 23651 | AFLAC | $5K | — | $5K | 1.06% |
| GREGORY TEATOR3 | 524 TROUTWOOD PLACE FUQUAY VARINA, NC 27526 | AFLAC | $3K | $368 | $3K | 0.67% |
| LARRY WESTON JR3 Filed as: LARRY WESTON JR. | 321 WINDSOR ROAD GREENVILLE, NC 27858 | AFLAC | $2K | $436 | $3K | 0.56% |
| ELIZABETH MANGUM3 | 3919 WENTWORTH DRIVE DURHAM, NC 27707 | AFLAC | $2K | — | $2K | 0.48% |
| WILLIAM L BAKER IV3 Filed as: WILLIAM BAKER IV | 2310 S MIAMI BLVD STE 239 DURHAM, NC 27703 | AFLAC | $2K | $11 | $2K | 0.34% |
| TEATOR'S INS PROTECTION SERVICES3 | 524 TROUTWOOD PLACE FUQUAY VARINA, NC 27526 | AFLAC | $1K | $118 | $1K | 0.30% |
| JILL DENTON3 | 3500 WESTGATE DRIVE, SUITE 602 DURHAM, NC 27707 | AFLAC | $1K | — | $1K | 0.25% |
| STANLEY FLOYD3 | 550 TERRELL LANE LOISBURG, NC 27549 | AFLAC | $919 | — | $919 | 0.20% |
| DAVID BAKER3 | 1531 SUNFLOWER FIELD PLACE MATTHEWS, NC 28104 | AFLAC | $792 | — | $792 | 0.18% |
| NATHANIEL REWEY3 | 186 WAVERLEY STREET ARLINGTON, MA 02476 | AFLAC | $711 | — | $711 | 0.16% |
| JERRY OLIVER CREECH3 Filed as: JERRY CREECH | 233 MIDDLE STREET, SUITE 107 A NEW BERN, NC 28560 | AFLAC | $653 | — | $653 | 0.14% |
| GARY TURNER3 | 1 EAGLE DRIVE DURHAM, NC 27712 | AFLAC | $604 | — | $604 | 0.13% |
| THOMAS PEARSON3 | 708 VILLAWOOD COURT RALEIGH, NC 27615 | AFLAC | $560 | — | $560 | 0.12% |
| BRIDGETT DAIL3 | 5217 STONE STATION DRIVE RALEIGH, NC 27616 | AFLAC | $519 | — | $519 | 0.11% |
| STEPHEN W CROTTS SR3 Filed as: STEPHEN CROTTS SR | 514 E 3RD STREET UNIT C SILER CITY, NC 27344 | AFLAC | $434 | — | $434 | 0.10% |
| DAVID MORGAN3 | 906 MERCHANT LEE PLACE MANAKIN SABOT, VA 23103 | AFLAC | $290 | — | $290 | 0.06% |
| TERRI G MOOSE3 Filed as: TERRI MOOSE | 1516 MAIDEN LANE WINSTON SALEM, NC 27104 | AFLAC | $246 | — | $246 | 0.05% |
| SUSAN RUSSELL3 | 921 MALLARD CIRCLE ARNOLD, MD 21012 | AFLAC | $207 | — | $207 | 0.05% |
| D AND V BUTLER INC3 Filed as: J BUTLER | 1440 OLD LENOIR ROAD, SUITE A HICKORY, NC 28601 | AFLAC | $156 | — | $156 | 0.03% |
| GARY GREENE3 | 1609 W ARLINTON BLVD. SUITE 102 GREENVILLE, NC 27858 | AFLAC | $87 | $42 | $129 | 0.03% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: THOMAS KELLY & ASSOCIATES INC. | 2329 COLINGTON ROAD KILL DEVIL HILLS, NC 27948 | AFLAC | $67 | — | $67 | 0.01% |
| KIMBERLY STATEN3 | PO BOX 8184 GRAY, TN 37615 | AFLAC | $46 | — | $46 | 0.01% |
| STEVEN KAISER3 | 4120 OLD BARK WAY CUMMING, GA 30041 | AFLAC | $40 | — | $40 | 0.01% |
| GLENN E LUOMA3 | 302 WATSON ROAD LOT I TAYLORS, SC 29687 | AFLAC | $36 | — | $36 | 0.01% |
| GERALD MEGGETT3 | 12020 SWALLOW FALLS COURT SILVER SPRING, MD 20904 | AFLAC | $26 | — | $26 | 0.01% |
| SHEM J BOSTICK3 Filed as: SHEM BOSTICK | 1325 MOUNT HERMON ROAD, SUITE 13B SALISBURY, MD 21804 | AFLAC | $24 | — | $24 | 0.01% |
| PAMELA BEECH-WHALEY3 | PO BOX 250251 ATLANTA, GA 30325 | AFLAC | $21 | — | $21 | 0.00% |
| SUSAN N ADAMS3 Filed as: SUSAN ADAMS | 4104 E PARHAM ROAD, SUITE A RICHMOND, VA 23228 | AFLAC | $21 | — | $21 | 0.00% |
| C HUDSON AND ASSOCIATES3 | 2843 TWIN PINE ROAD THOMSON, GA 30824 | AFLAC | $18 | — | $18 | 0.00% |
| KESIA CHANG3 | 4633 10TH AVENUE NORTH LAKE WORTH, FL 33463 | AFLAC | $17 | — | $17 | 0.00% |
| CHARLES HOUGH3 | 162 SLATE HILL ROAD TELFORD, TN 37690 | AFLAC | $15 | — | $15 | 0.00% |
| EVERETT C BENNETT3 Filed as: EVERETT BENNETT | 902 POPLAR STREET MILFORD, DE 19963 | AFLAC | $12 | — | $12 | 0.00% |
| LAURA HEILIG3 | 13768 OAK TREE TERRACE JACKSONVILLE, FL 32224 | AFLAC | $11 | — | $11 | 0.00% |
| HAMIDA M TRAINOR3 Filed as: HAMIDA TRAINOR | 2608 MEADOW ROAD WEST PALM BEACH, FL 33406 | AFLAC | $10 | — | $10 | 0.00% |
| LOIRE LUCAS3 | 2120 SW DANFORTH CIRCLE PALM CITY, FL 34990 | AFLAC | $9 | — | $9 | 0.00% |
| ABBIE W COFFMAN3 Filed as: ABBIE COFFMAN | 31 HAWTHORN CIRCLE CROSSVILLE, TN 38555 | AFLAC | $8 | — | $8 | 0.00% |
| KENNETH FRANK JR3 Filed as: KENNETH FRANK JR. | 8091 SIERRA OAKS BLVD. JACKSONVILLE, FL 32219 | AFLAC | $8 | — | $8 | 0.00% |
| DEININGER BENEFITS ADVISORS INC3 Filed as: DEININGER BENEFITS ADVISORS INC. | PO BOX 372696 SATELLITE BEACH, FL 32937 | AFLAC | $7 | — | $7 | 0.00% |
| LANCE PITTMAN LLC3 Filed as: LANCE PITTMAN | 125 LITTLE HAWK PLACE MIDLOTHIAN, VA 23114 | AFLAC | $7 | — | $7 | 0.00% |
| DAVID MORNINGSTAR3 | 11285 DOVEDALE COURT 2ND FLOOR MARRIOTTSVILLE, MD 21104 | AFLAC | $6 | — | $6 | 0.00% |
| DAVID K MOBLEY3 Filed as: DAVID MOBLEY | 3812 VALVERDE CIRCLE JACKSONVILLE, FL 32224 | AFLAC | $6 | — | $6 | 0.00% |
| JEFFREY GURLEY3 | PO BOX 1434 GOLDSBORO, NC 27533 | AFLAC | $6 | — | $6 | 0.00% |
| FRANCES SHAFFER3 | 14025 TOWER ROAD SMITHBURG, MD 21783 | AFLAC | $6 | — | $6 | 0.00% |
| DANIEL HIGHSMITH3 Filed as: DANIEL D REECE | 224 LONGSTREET XING NORTH AUGUSTA, SC 29860 | AFLAC | $6 | — | $6 | 0.00% |
| DUANE A ADAMS3 Filed as: DUANE ADAMS | 11520 NUCKOLS ROAD SUITE 103 GLEN ALLEN, VA 23059 | AFLAC | $6 | — | $6 | 0.00% |
| ANN FINLAY3 | 3335 SAVANNAHS TRAIL MERRITT ISLAND, FL 32953 | AFLAC | $6 | — | $6 | 0.00% |
| BARRY CAMPBELL3 | 2798 COUNTY ROAD 80 ALGER, OH 45812 | AFLAC | $6 | — | $6 | 0.00% |
| JOSHUA BUZZARD3 | 7458 TRESCOTT DRIVE LAKE WORTH, FL 33467 | AFLAC | $5 | — | $5 | 0.00% |
| MARK FALBO3 | 2610 CRYSTAL COVE COURT JACHSONVILLE, FL 32224 | AFLAC | $5 | — | $5 | 0.00% |
| CYNTHIA DROPESKI3 | 690 W EAU GALLIE BLVD. MELBOURNE, FL 32935 | AFLAC | $5 | — | $5 | 0.00% |
| ROBERT L TRAPNELL JR3 Filed as: ROBERT TRAPNELL JR | 19 N INDIAN RIVER DRIVE APT 701 COCOA, FL 32922 | AFLAC | $4 | — | $4 | 0.00% |
| THOMAS ROBERT GIDDENS3 Filed as: THOMAS GIDDENS | PO BOX 2517 KENNESAW, GA 30156 | AFLAC | $4 | — | $4 | 0.00% |
| JOHN ALEXANDER3 | PO BOX 320310 COCOA, FL 32932 | AFLAC | $4 | — | $4 | 0.00% |
| ERNEST YOUNGBLOOD3 | 718 MONTMORENCI ROAD AIKEN, SC 29801 | AFLAC | $4 | — | $4 | 0.00% |
| JACKSON D RHODES3 Filed as: JACKSON RHODES | 525 W OAKLAND AVENUE, SUITE 7 JOHNSON CITY, TN 37604 | AFLAC | $4 | — | $4 | 0.00% |
| JANET PARRY3 | PO BOX 243 CAPE CHARLES, VA 23310 | AFLAC | $3 | — | $3 | 0.00% |
| DENNIS C LINDEY3 Filed as: DENNIS LINDEY | PO BOX 1082 GOODLETTSVILLE, TN 37070 | AFLAC | $2 | — | $2 | 0.00% |
| CHRISTOPHER EDDY3 | 316 PONTEVEDRA LANE NICEVILLE, FL 32578 | AFLAC | $2 | — | $2 | 0.00% |
| RONALD E KIRKLAND3 Filed as: RONALD KIRKLAND | 1044 HARBOR RIDGE ROAD GUNTERSVILLE, AL 35976 | AFLAC | $2 | — | $2 | 0.00% |
| ALFRED RIETKERK3 | 3120 NE 47TH STREET FORT LAUDERDALE, FL 33308 | AFLAC | $2 | — | $2 | 0.00% |
| JACQUELINE VIZCAINO-SUDDRETH3 | 72 DRISKELL AVENUE SW MABLETON, GA 30126 | AFLAC | $2 | — | $2 | 0.00% |
| DORIS L BRACKETT3 Filed as: DORIS BRACKETT | 3233 HIGHGATE CHASE COURT BERKELEY LAKE, GA 30092 | AFLAC | $2 | — | $2 | 0.00% |
| CHARLES BONO3 | PO BOX 5506 WILLIAMSBURG, VA 23188 | AFLAC | $1 | — | $1 | 0.00% |
| RONALD TRULUCK3 | 1934 PANTHEON DRIVE WINTER GARDEN, FL 34787 | AFLAC | $1 | — | $1 | 0.00% |
| NORWOOD RANDY JONES3 Filed as: NORWOOD JONES | PO BOX 802 PRINCETON, NC 27569 | AFLAC | $1 | — | $1 | 0.00% |
| WILLIAM WARDLAW JR3 Filed as: WILLIAM WARDLAW JR. | 5300 OAKBROOK PKWY BLDG 300 STE 350 NORCROSS, GA 30093 | AFLAC | $1 | — | $1 | 0.00% |
| BENJAMIN O THOMPSON SR3 Filed as: BENJAMIN THOMPSON SR. | 2012 GAMELAW COURT MIDLOTHIAN, VA 23113 | AFLAC | $1 | — | $1 | 0.00% |
| JAMES A SCOTT & SON INC3 Filed as: JAMES A SCOTT & SON INC. | 628 GREEN VALLEY ROAD, SUITE 306 GREENSBORO, NC 27408 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $4K | $4K | 1.79% |
| JAMES A SCOTT & SON INC3 Filed as: JAMES A SCOTT & SON INC. | 628 GREEN VALLEY ROAD, SUITE 306 GREENSBORO, NC 27408 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $4K | $4K | 1.78% |
| JAMES A SCOTT & SON INC3 Filed as: JAMES A SCOTT & SON INC. | 628 GREEN VALLEY ROAD, SUITE 306 GREENSBORO, NC 27408 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $3K | $3K | 1.77% |
| JAMES A SCOTT & SON INC3 Filed as: JAMES A SCOTT & SON INC. | 628 GREEN VALLEY ROAD, SUITE 306 GREENSBORO, NC 27408 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $155 | $155 | 1.80% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 ADMINISTRATION | Direct payment from the plan; Claims processing; Non-monetary compensation; Other services; Named fiduciary; Contract Administrator; Float revenue; Participant communication Service code 12 | — | $352K |
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 | 731 | 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) | 731 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AFLAC | 415 | $452K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,593 | $1.2M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,078 | $215K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 292 | $170K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 474 | $250K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,593 | $1.2M |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 731 | $9K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,593 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.