| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62819 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $8K | $558 | $8K | 16.08% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62689 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $4 | $0 | $4 | 0.01% |
| USI INSURANCE SERVICES LLC3 | 6100 FAIRVIEW ROAD CHARLOTTE, NC 28210 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $892 | $5 | $897 | 6.44% |
| ROBERT WOODFIN3 | 2401 FRASERBURGH DRIVE MATTHEWS, NC 28105 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $152 | $10 | $162 | 1.16% |
| CRYSTAL R GUPTON3 Filed as: CRYSTAL R. GUPTON | 200 LA FORET DRIVE MORGANTON, NC 28655 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $33 | $0 | $33 | 0.24% |
| PAMELA COPLE SMITH3 | 411 HIGHLAND DRIVE SEATTLE, WA 98109 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $23 | $0 | $23 | 0.17% |
| COLLEEN A VOGAN3 Filed as: COLLEEN A. VOGAN | 241 TWENG TRAIL LEXINGTON, SC 29072 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $15 | $0 | $15 | 0.11% |
| GRIMES INSURANCE LLC3 Filed as: GRIMES INSURANCE, LLC | 2728 HUNTINGTON ROAD FAYETTEVILLE, NC 28303 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4 | $5 | $9 | 0.06% |
| USI INSURANCE SERVICES LLC3 | 6100 FAIRVIEW ROAD CHARLOTTE, NC 28210 | THE PAUL REVERE LIFE INSURANCE COMPANY | $12 | $0 | $12 | 0.82% |
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 | 180 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 183 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 73 | $53K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 22 | $14K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 73 | $51K |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 73 | $65K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 73 | — |
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.