| 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 | $931 | $9K | 11.11% |
| MJ INSURANCE3 Filed as: INSYNC BENEFITS AND VARIOUS AGENTS | PO BOX 1474 CORNELIUS, NC 28031 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $69 | $1K | 2.51% |
| SHELLEY HARTSELL3 Filed as: SHELLEY CAMPBELL HARTSELL | 21317 COUNTRY CLUB DRIVE CORNELIUS, NC 28031 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $939 | $283 | $1K | 2.29% |
| USI INSURANCE SERVICES LLC3 | 6100 FAIRVIEW ROAD CHARLOTTE, NC 28210 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $35 | $1K | 2.04% |
| CAROLINA BENEFITS SOURCE INC3 Filed as: CAROLINA BENEFITS SOURCE, INC. | 4461 NE 30TH AVENUE LIGHTHOUSE POINT, NC 33064 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $801 | $0 | $801 | 1.50% |
| BETTER CHOICE HEALTH LLC3 Filed as: BETTER CHOICE HEALTH, LLC | 4461 NE 30TH AVENUE LIGHTHOUSE POINT, NC 33064 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $473 | $121 | $594 | 1.12% |
| PETER MICHAEL FOLEY JR3 Filed as: PETER MICHAEL FOLEY JR. | 30 GROVESIDE ROAD PORTLAND, ME 04102 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $242 | $0 | $242 | 0.45% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES SE, INC. | 1901 ROXBOROUGH ROAD CHARLOTTE, NC 28211 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $192 | $0 | $192 | 0.36% |
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 | 114 | 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) | 114 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | HARTFORD LIFE AND ACCIDENT | 106 | $84K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 106 | $84K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 106 | $84K |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 106 | $137K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 106 | — |
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.