| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| C2-COLLABORATION CENTRIC SOLUTIONS3 | PO BOX 6824 GRAND RAPIDS, MI 49516 | UNIMERICA INSURANCE COMPANY | $18K | — | $18K | 3.00% |
| SCOTT INSURANCE3 | 1301 OLD GRAVES MILL ROAD LYNCHBURG, VA 24502 | UNIMERICA INSURANCE COMPANY | $12K | — | $12K | 2.00% |
| THE CASON GROUP INC3 Filed as: THE CASON GROUP | PO BOX 11229 COLUMBIA, SC 29211 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $14K | — | $14K | 37.81% |
| THE WORKSITE GROUP LLC3 Filed as: WORKSITE SERVICES, INC. | PO BOX 327 GARNER, NC 27529 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $633 | — | $633 | 1.66% |
| JAMES A SCOTT & SON INC3 | PO BOX 603438 CHARLOTTE, NC 28260 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $339 | — | $339 | 0.89% |
| THE CASON GROUP INC3 Filed as: THE CASON GROUP | PO BOX 11229 COLUMBIA, SC 29211 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $5K | — | $5K | 35.98% |
| THE WORKSITE GROUP LLC3 Filed as: WORKSITE SERVICES, INC. | PO BOX 327 GARNER, NC 27529 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $232 | — | $232 | 1.54% |
| JAMES A SCOTT & SON INC3 | PO BOX 603438 CHARLOTTE, NC 28260 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $130 | — | $130 | 0.86% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $264K |
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 | 339 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 346 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 84 | $53K |
| Dental | DELTA DENTAL OF NORTH CAROLINA | 575 | $216K |
| Vision | COMMUNITY EYE CARE | 469 | $21K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 450 | $68K |
| Short-term disability(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 339 | $75K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 339 | $34K |
| Stop-loss / reinsurancereinsurance | UNIMERICA INSURANCE COMPANY | 330 | $599K |
| Other(2 contracts, 2 carriers) | ESPYR (EAP) | 415 | $9K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 575 | — |
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."
No prospect flags tripped on this filing.