| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $38K | $38K | 5.00% |
| TRIANGLE INSURANCE & ASSOCIATES LLC3 Filed as: TRIANGLE INSURANCE & ASSOCIATES | 222 NORTH BICKETT BOULEVARD LOUISBURG, NC 27549 | CONTINENTAL AMERICAN INSURANCE COMPANY | $48K | — | $48K | 17.86% |
| BURNETTE INSURANCE AGENCY3 Filed as: BURNETTE INSURANCE GROUP, INC | 6297 N.C. 561 HIGHWAY LOUISBURG, NC 27549 | CONTINENTAL AMERICAN INSURANCE COMPANY | $21K | — | $21K | 7.66% |
| LOCKTON COMPANIES, LLC3 | 340 SEVEN SPRINGS WAY, SUITE 750 BRENTWOOD, TN 37027 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $12K | $12K | 4.47% |
| LOCKTON COMPANIES, LLC3 | 340 SEVEN SPRINGS WAY, SUITE 750 BRENTWOOD, TN 37027 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $9K | $9K | 4.82% |
| LOCKTON COMPANIES, LLC3 | 340 SEVEN SPRINGS WAY, SUITE 750 BRENTWOOD, TN 37027 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $9K | $9K | 4.74% |
| LOCKTON COMPANIES, LLC3 | 340 SEVEN SPRINGS WAY, SUITE 750 BRENTWOOD, TN 37027 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 4.82% |
| LOCKTON COMPANIES, LLC3 | 340 SEVEN SPRINGS WAY, SUITE 750 BRENTWOOD, TN 37027 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 4.50% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX, INC. EIN 33-0441200 RX BENEFIT MANAGEMENT | Claims processing; Direct payment from the plan; Other fees; Float revenue Service code 12 | — | $2.5M |
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $103K |
| DELTA DENTAL OF NORTH CAROLINA EIN 13-2698638 ADMINISTRATOR | Contract Administrator Service code 13 | — | $28K |
| UNITED OF OMAHA LIFE INSURANCE CO. EIN 47-0322111 ADMINISTRATOR | Contract Administrator Service code 13 | — | $4K |
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 | 634 | 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) | 634 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CONTINENTAL AMERICAN INSURANCE COMPANY | 360 | $270K |
| Vision | VISION SERVICE PLAN | 630 | $76K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 789 | $233K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 348 | $189K |
| Long-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 335 | $303K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 634 | $756K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 789 | $51K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 789 | — |
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.