| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: SENN DUNN MARSH & MCLENNAN AGENCY | PO BOX 9395 GREENSBORO, NC 27429 | HUMANA DENTAL INSURANCE COMPANY | $11K | $2K | $13K | 13.66% |
| IBSI HOLDINGS INC3 | PO BOX 24337 WINSTON SALEM, NC 27114 | HUMANA DENTAL INSURANCE COMPANY | $5K | — | $5K | 5.35% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX AGENCY INC-ROCHESTER | 150 SAWGRASS DRIVE ROCHESTER, NY 14620 | HUMANA DENTAL INSURANCE COMPANY | $1K | — | $1K | 1.11% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 9375 GREENSBORO, NC 27429 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 14.02% |
| MARSH & MCLENNAN AGENCY LLC3 | 2301 SUGAR BUSH ROAD RALEIGH, NC 27612 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $2K | $2K | 2.42% |
| ARTHUR WAYNE JORDAN JR3 | 514 OAKWOOD AVENUE RALEIGH, NC 27601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $424 | $127 | $551 | 1.36% |
| WILLIAM T MILLER3 | 2908 OTRANTO ROAD NORTH CHARLESTON, SC 29406 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $407 | — | $407 | 1.00% |
| USI INSURANCE SERVICES LLC3 | 8049 CORPORATE CENTER DRIVE CHARLOTTE, NC 28226 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $235 | — | $235 | 0.58% |
| CONTEMPORARY BENEFITS ADVISORS LLC3 Filed as: CONTEMPORARY BENEFITS DESIGN INC | 1956 WELLNESS BOULEVARD MONROE, NC 28110 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $211 | — | $211 | 0.52% |
| BENEFITS COUNT INC3 Filed as: BENEFITS COUNT I INC | 248 RIVERWOOD DRIVE LEWISVILLE, NC 27023 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $133 | — | $133 | 0.33% |
| PETER MICHAEL FOLEY JR3 | 150 PAMPLICO LANE MOORESVILLE, NC 28117 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $131 | — | $131 | 0.32% |
| KJELL T TERRELL3 | 327 GOLF COURSE DRIVE RALEIGH, NC 27610 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $122 | $3 | $125 | 0.31% |
| CRYSTAL R GUPTON3 | 2138 GOODMAN LAKE ROAD MORGANTON, NC 28655 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $107 | — | $107 | 0.26% |
| RYLEE ENTERPRISES INC3 | 1828 OAK RIDGE ROAD OAK RIDGE, NC 27310 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $98 | — | $98 | 0.24% |
| MARK PAGE3 | 311 MARSH OAKS DRIVE WILMINGTON, NC 28411 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $91 | — | $91 | 0.22% |
| SUSAN FONTENOT3 | 10717 DAPPLE GREY LANE CHARLOTTE, NC 28213 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $51 | $1 | $52 | 0.13% |
| BARRY RUSSELL3 | 22 GRACKLE DRIVE PAWLEYS ISLAND, SC 29585 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $50 | — | $50 | 0.12% |
| GRAEM M CLARK3 | 589 WINDMERE DRIVE LEXNGTON, SC 29072 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $50 | — | $50 | 0.12% |
| RUTH A SUTTLE3 | 1414 MOUNTAIN SHADOWS DRIVE MORGANTON, NC 28655 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $31 | — | $31 | 0.08% |
| COLLEEN A VOGAN3 | 5018 COBBLESTONE COURT ELLICOTT CITY, MD 21043 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | — | $12 | 0.03% |
| LAURIE J BURNS3 | 303 PLYLER ROAD INDIAN TRAIL, NC 28079 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | — | $12 | 0.03% |
| PAMELA GREGG3 | 15004 SAINT THOMAS CHURCH ROAD UPPER MARLBORO, MD 20772 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.01% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 9375 GREENSBORO, NC 27429 | UNUM LIFE INSURANCE COMAPNY OF AMERICA | $3K | — | $3K | 13.91% |
| MARSH & MCLENNAN AGENCY LLC3 | 2301 SUGAR BUSH ROAD RALEIGH, NC 27612 | UNUM LIFE INSURANCE COMAPNY OF AMERICA | — | $563 | $563 | 2.40% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY, LLC | 3625 NORTH ELM STREET GREENSBORO, NC 27455 | VISION SERVICE PLAN | $699 | — | $699 | 4.00% |
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 | 277 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 278 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 241 | $827K |
| Dental | HUMANA DENTAL INSURANCE COMPANY | 184 | $97K |
| Vision | VISION SERVICE PLAN | 148 | $17K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 273 | $89K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 273 | $65K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 273 | $65K |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 273 | $129K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 273 | — |
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.