| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62689 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $6K | $0 | $6K | 15.00% |
| USI INSURANCE SERVICES LLC3 | 8049 CORPORATE CENTER DRIVE CHARLOTTE, NC 28226 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $86 | $3K | 11.61% |
| ROBERT WOODFIN3 | 2401 FRASERBURGH DRIVE MATTHEWS, NC 28105 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $581 | $9 | $590 | 2.48% |
| JULIAN EMERSON3 | PO BOX 598 GEORGETOWN, SC 29442 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $20 | $123 | $143 | 0.60% |
| CRYSTAL R GUPTON3 Filed as: CRYSTAL R. GUPTON | 2138 GOODMAN LAKE ROAD MORGANTON, NC 28655 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $97 | $0 | $97 | 0.41% |
| PAMELA COPLE SMITH3 Filed as: PAMELA C. SMITH AND OTHER AGENTS | 411 HIGHLAND SEATTLE, WA 98109 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $64 | $7 | $71 | 0.30% |
| KEITH CONLEY3 | 101 LAUREL HILLS DRIVE MORGANTON, NC 28655 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $66 | $0 | $66 | 0.28% |
| S AND M HOMES, LLC3 | 2375 RAEFORD ROAD FAYETTEVILL, NC 28305 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $21 | $6 | $27 | 0.11% |
| USI INSURANCE SERVICES LLC3 | 8049 CORPORATE CENTER DRIVE CHARLOTTE, NC 28226 | THE PAUL REVERE LIFE INSURANCE COMPANY | $25 | $0 | $25 | 1.00% |
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 | 167 | 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) | 167 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 81 | $46K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 40 | $24K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 81 | $43K |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 81 | $67K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 81 | — |
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.