| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MICHELSEN BENEFITS GROUP, INC.3 Filed as: MICHELSEN, WILLIAM L | 1901 ROXBOROUGH ROAD SUITE 300 CHARLOTTE, NC 28211 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | — | $10K | $10K | 0.97% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX AGENCY INC-ROCHESTER | 150 SAWGRASS DRIVE ROCHESTER, NY 14620 | HUMANADENTAL INSURANCE COMPANY | $12K | $5K | $17K | 17.08% |
| IBSI HOLDINGS INC3 | PO BOX 24337 WINSTON SALEM, NC 27114 | HUMANADENTAL INSURANCE COMPANY | $462 | — | $462 | 0.46% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: SENN DUNN MARSH & MCLENNAN AGENCY L | PO BOX 9395 GREENSBORO, NC 27429 | HUMANADENTAL INSURANCE COMPANY | $8 | — | $8 | 0.01% |
| PAYCHEX INSURANCE AGENCY, INC.3 | 150 SAWGRASS DRIVE ROCHESTER, NY 14450 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 12.00% |
| BENEFITS COUNT INC3 Filed as: BENEFITS COUNT LI INC | 1401 CHRISTMAS COURT RALEIGH, NC 27604 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $998 | $173 | $1K | 3.61% |
| CAROLINA BENEFITS SOURCE INC3 | 4461 NORTHEAST 30TH AVENUE LIGHTHOUSE PT, FL 33064 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $247 | — | $247 | 0.76% |
| USI INSURANCE SERVICES LLC3 | 8049 CORPORATE CENTER DRIVE CHARLOTTE, NC 28226 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $231 | — | $231 | 0.71% |
| ARTHUR WAYNE JORDAN JR3 | 514 OAKWOOD AVENUE RALEIGH, NC 27601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $202 | $28 | $230 | 0.71% |
| KJELL T TERRELL3 | 327 GOLF COURSE DRIVE RALEIGH, NC 27610 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $123 | $11 | $134 | 0.41% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES SE INC | 1956 WELLNESS BOULEVARD MONROE, NC 28110 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $130 | — | $130 | 0.40% |
| BENEFITS COUNT INC3 Filed as: BENEFITS COUNT I INC | 248 RIVERWOOD DRIVE LEWISVILLE, NC 27023 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $126 | — | $126 | 0.39% |
| DONNA LEE MORE3 | 1804 FAIRVIEW ROAD RALEIGH, NC 27608 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $97 | $22 | $119 | 0.37% |
| MARK PAGE3 | 311 MARSH OAKS DRIVE WILMINGTON, NC 28411 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $83 | — | $83 | 0.26% |
| PETER MICHAEL FOLEY JR3 | 150 PAMPLICO LANE MOORESVILLE, NC 28117 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $81 | — | $81 | 0.25% |
| CRYSTAL R GUPTON3 | 2138 GOODMAN LAKE ROAD MORGANTON, NC 28655 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $79 | — | $79 | 0.24% |
| THE CLARK GROUP OF SC3 | 589 WINDMERE DRIVE LEXINGTON, SC 29072 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $47 | — | $47 | 0.15% |
| CONTEMPORARY BENEFITS ADVISORS LLC3 Filed as: CONTEMPORARY BENEFITS DESIGN INC | 1956 WELLNESS BOULEVARD MONROE, NC 28110 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $46 | — | $46 | 0.14% |
| INSYNC BENEFITS INC3 | PO BOX 1474 CORNELIUS, NC 28031 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $35 | — | $35 | 0.11% |
| NORWOOD BENEFIT SERVICES INC3 | 6478 LONG BREEZE ROAD ORLANDO, FL 32810 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $35 | — | $35 | 0.11% |
| SUSAN FONTENOT3 | 10717 DAPPLE GREY LANE CHARLOTTE, NC 28213 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $32 | — | $32 | 0.10% |
| TULLY AND COMPANY INC3 | 1926 STONE BRIDGE LANE MARIETTA, GA 30064 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $28 | — | $28 | 0.09% |
| RYLEE ENTERPRISES INC3 | 1828 OAK RIDGE ROAD OAK RIDGE, NC 27310 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $23 | — | $23 | 0.07% |
| ADVANCED BENEFIT SYSTEM INC3 | 245 SEVEN FARMS DRIVE DANIEL ISLAND, SC 29492 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $23 | — | $23 | 0.07% |
| STATE EMPLOYEE BENEFITS LLC3 | PO BOX 365 HOPE MILLS, NC 28348 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $22 | — | $22 | 0.07% |
| PIERCE GROUP BENEFITS LLC3 | 4928 LINKSLAND DRIVE HOLLY SPRINGS, NC 27540 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $22 | — | $22 | 0.07% |
| BRIAN COHEN3 | 701 LEORA LANE THE COLONY, TX 75056 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17 | — | $17 | 0.05% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX INSURANCE AGENCY INC | 150 SAWGRASS DRIVE ROCHESTER, NY 14620 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | $2 | $15 | 0.05% |
| COLLEEN A VOGAN3 | 5018 COBBLESTONE COURT ELLICOTT CITY, MD 21043 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | — | $13 | 0.04% |
| LAURIE J BURNS3 | 303 PLYER ROAD INDIAN TRAIL, NC 28079 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | — | $10 | 0.03% |
| KRISTEN BIBLE3 | 5461 TRALEE PLACE RALEIGH, NC 27609 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.02% |
| BARRETT L PATTERSON3 | PO BOX 10641 RALEIGH, NC 27605 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $2 | $6 | 0.02% |
| RUTH A SUTTLE3 | 1414 MOUNTAIN SHADOWS DRIVE MORGANTON, NC 28655 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.02% |
| DAVID SPARKS PURVIS3 | 3840 SADDLE BEND DRIVE OLIVE BRANCE, MS 38654 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.01% |
| PAMELA GREGG3 | 15001 SAINT THOMAS CHURCH ROAD UPPER MARLBORO, MD 20772 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.01% |
| BARRY RUSSELL3 | 3182 CONSERVANCY LANE CHARLESTON, SC 29414 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.01% |
| WILLIAM T MILLER3 | 2908 OTRANTO ROAD NORTH CHARLESTON, SC 29406 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.01% |
| DONALD H MATSON3 | 8 ROSEWOOD DRIVE AUBURN, NY 13021 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| CLAUDIA MARABOTO3 | 130 TIERRA MONTANOSA RANCHO SANTO MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| PAYCHEX INSURANCE AGENCY, INC.3 | 150 SAWGRASS DRIVE ROCHESTER, NY 14620 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $466 | $3K | 14.00% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX INSURANCE AGENCY INC | PO BOX 498 HENRIETTA, NY 14467 | VISION SERVICE PLAN | $923 | — | $923 | 6.21% |
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 | 243 | 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) | 243 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 159 | $1.0M |
| Dental | HUMANADENTAL INSURANCE COMPANY | 171 | $100K |
| Vision | VISION SERVICE PLAN | 151 | $15K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 330 | $93K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 330 | $70K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 330 | $70K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 159 | $1.0M |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 330 | $125K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 330 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.