| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KENNETH W HARVEY3 | 717 WREN RD GASTONIA, NC 28056 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $10K | — | $10K | 16.66% |
| KENNETH W HARVEY3 | 832 WREN RD GASTONIA, NC 28056 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | — | $3K | 14.10% |
| CORPORATE BENEFITS SERVICE, INC.3 | 9101 SOUTHERN PINE BLVD STE 30 CHARLOTTE, NC 28273 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | — | $1K | 8.43% |
| CORPORATE BENEFITS SERVICE, INC.3 Filed as: CORPORATE BENEFITS SERVICE, INC | PO BOX 11937 CHARLOTTE, NC 28220 | UNITED HEALTHCARE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CORPORATE BENEFITS SERVICE, INC. EIN 56-1167792 NONE | Insurance agents and brokers Service code 22 | — | $53K |
| CULPEPPER DEVEREAUX EIN 25-1912027 NONE | Insurance agents and brokers Service code 22 | — | $30K |
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 | 213 | 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) | 213 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 234 | $71K |
| Short-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 205 | $80K |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 205 | $91K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 234 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.