| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CONNI L RIPPY3 | 361 N RIDGE CIR ROXBORO, NC 27574 | AFLAC | $1K | — | $1K | 3.10% |
| KELSIE HORNER3 | 302 MABEL LN ROXBORO, NC 27574 | AFLAC | $1K | — | $1K | 2.80% |
| REBECCA MAYES3 | 6670 HELENA MORIAH RD ROUGEMONT, NC 27572 | AFLAC | $631 | — | $631 | 1.45% |
| T P SYKES LLC3 | 1274 SILKY WILLOW DR WAKE FOREST, NC 27587 | AFLAC | $265 | — | $265 | 0.61% |
| SIMERSON & ASSOCIATES INC3 | 3810 SOWERS RD LINWOOD, NC 27299 | AFLAC | $257 | — | $257 | 0.59% |
| PATRICIA G HORNER3 | 302 MABEL LN ROXBORO, NC 27574 | AFLAC | $225 | — | $225 | 0.52% |
| NATHANIEL C REWEY3 | 5 PARKER ST LEXINGTON, MA 02421 | AFLAC | $199 | — | $199 | 0.46% |
| WILLIAM L BAKER IV3 | 1121 WEDGELAND DR RALEIGH, NC 27615 | AFLAC | $190 | — | $190 | 0.44% |
| JILL R LAMBERT3 Filed as: JILL W DENTON | 3500 WESTGATE DR STE 602 DURHAM, NC 27707 | AFLAC | $136 | — | $136 | 0.31% |
| BRENDA LYNN GARRETT3 | 12475 KENTWOOD AVE FORT MYERS, FL 33913 | AFLAC | $117 | — | $117 | 0.27% |
| ELIZABETH MANGUM3 Filed as: ELIZABETH W MANGUM | 3919 WESTWORTH DR DURHAM, NC 27707 | AFLAC | $111 | — | $111 | 0.25% |
| JAMES W RAEFORD3 | 208 S GRIST MILL RD HAMPSTEAD, NC 28443 | AFLAC | $97 | — | $97 | 0.22% |
| DONNA N DWYER3 Filed as: DONNA W WACHTER | 2072 1/2 S HAWTHORNE RD WINSTON SALEM, NC 27103 | AFLAC | $84 | — | $84 | 0.19% |
| CAROLINE HOWARD PEARCE3 | 1206 COLONIAL AVE GREENSBORO, NC 27408 | AFLAC | $66 | — | $66 | 0.15% |
| TEATOR'S INS PROTECTION SERVICES3 | 524 TROUTWOOD PL FUQUAY VARINA, NC 27526 | AFLAC | $57 | — | $57 | 0.13% |
| JENNIFER L VANROWKEL3 | 212 LEE TRACE DR SMITHFIELD, NC 27577 | AFLAC | $56 | — | $56 | 0.13% |
| KATHERINE L SIMOS3 | 1605 CONRAD RD LEWISVILLE, NC 27023 | AFLAC | $52 | — | $52 | 0.12% |
| THOMAS L LUEBCHOW3 | 390 PILOT RIDGE DR LEWISVILLE, NC 27023 | AFLAC | $51 | — | $51 | 0.12% |
| SUSAN F LAWS3 | 460 TANGLEWOOD CIR ROXBORO, NC 27573 | AFLAC | $49 | — | $49 | 0.11% |
| LARRY A WESTON JR3 | 321 WINDSOR RD GRENVILLE, NC 27858 | AFLAC | $44 | — | $44 | 0.10% |
| DAVID N MORGAN3 | 1904 ELLIS DR MAIDENS, VA 23102 | AFLAC | $42 | — | $42 | 0.10% |
| RYAN SCOTT SHADEL3 | 4801 GLENWOOD AVE STE 200 RALEIGH, NC 27612 | AFLAC | $42 | — | $42 | 0.10% |
| TITUS R HUNT3 | 2995 MABEL TRL BOONVILLE, NC 27011 | AFLAC | $40 | — | $40 | 0.09% |
| MATTHEW G WILLIAMS3 | 2495 WILLIAMS RD LEWISVILLE, NC 27023 | AFLAC | $35 | — | $35 | 0.08% |
| JACK ALBERTSON3 | 321 OLD ROCK RD CLARKSVILLE, VA 23927 | AFLAC | $30 | — | $30 | 0.07% |
| LISA WINTRODE3 Filed as: LISA S WINTRODE | 309 DOGWOOD DR DANVILLE, VA 24541 | AFLAC | $28 | — | $28 | 0.06% |
| DAVID GIBIDES3 | 3766 WORTHINGTON CIR COLLEGEVILLE, PA 19426 | AFLAC | $27 | — | $27 | 0.06% |
| PAUL J MALO3 | PO BOX 38 FIRESTONE, CO 80520 | AFLAC | $26 | — | $26 | 0.06% |
| KIM J WILLIAMS3 | 2685 WILLIAMS RD LEWISVILLE, NC 27023 | AFLAC | $26 | — | $26 | 0.06% |
| RUTH P YOUNG3 | 677 BERKMAR CT CHARLOTTESVILLE, VA 22901 | AFLAC | $23 | — | $23 | 0.05% |
| TERESA L SELLS3 | PO BOX 84 WEST JEFFERSON, NC 28694 | AFLAC | $23 | — | $23 | 0.05% |
| JANINE D HUSS3 | 108 CANTINA PL SAINT JOHNS, FL 32259 | AFLAC | $21 | — | $21 | 0.05% |
| KAREN B MATHIS3 | 3730 BURLINGTON RD ROXBORO, NC 27574 | AFLAC | $20 | — | $20 | 0.05% |
| LEWIS GALE3 | 276 W MILLBROOK RD RALEIGH, NC 27609 | AFLAC | $18 | — | $18 | 0.04% |
| JEFFREY J HARRIS3 | 7612 PERCY CT RALEIGH, NC 27613 | AFLAC | $18 | — | $18 | 0.04% |
| JERRY OLIVER CREECH3 | 5915 SANTO DOMINGO CT NEW BERN, NC 28560 | AFLAC | $18 | — | $18 | 0.04% |
| THOMAS R BADGETT3 | 418 PERCH LN SWANSBORO, NC 28584 | AFLAC | $16 | — | $16 | 0.04% |
| MARY FIELDER ADKINS3 | 1860 CANTER DR RINER, VA 24149 | AFLAC | $11 | — | $11 | 0.03% |
| C HARVEY KING3 | 931 S MAIN ST STE B #206 KERNERSVILLE, NC 27284 | AFLAC | $11 | — | $11 | 0.03% |
| REGINA G MARTIN3 | 1032 OCEAN BLVD W SUPPLY, NC 28462 | AFLAC | $11 | — | $11 | 0.03% |
| BRUCE A PETERSEN3 | 140 BIG BUCK TRL BOONE, NC 28607 | AFLAC | $11 | — | $11 | 0.03% |
| FAY JETER MARTIN3 | 19220 FOREST RD LYNCHBURG, VA 24502 | AFLAC | $10 | — | $10 | 0.02% |
| JEREMY M HASKELL3 | 430 RYDER CUP LN CLEMMONS, NC 27012 | AFLAC | $10 | — | $10 | 0.02% |
| TERRI G MOOSE3 | 168 BRADFORD PLACE LN LEWISVILLE, NC 27023 | AFLAC | $9 | — | $9 | 0.02% |
| K EARLE ABERNETHY3 | 2902 SHERYL DR KINSTON, NC 28504 | AFLAC | $8 | — | $8 | 0.02% |
| J MICHAEL BUTLER3 Filed as: J MICHAEL BUTER | 1090 13TH AVE NW HICKORY, NC 28601 | AFLAC | $8 | — | $8 | 0.02% |
| KELLY LEBSACK3 Filed as: KELLY D LEBSACK | 2084 COVERED BRIDGE PKWY WINDSOR, CO 80550 | AFLAC | $8 | — | $8 | 0.02% |
| J KYLE LAWRENCE3 | 2660 ASH ST DENVER, CO 80207 | AFLAC | $7 | — | $7 | 0.02% |
| LARRY W NICHOLSON3 Filed as: LARRY W W NICHOLSON | 861 N AUBURNDALE ST MEMPHIS, TN 38107 | AFLAC | $6 | — | $6 | 0.01% |
| THOMAS E HATCHER JR3 | 1588 BAY TREE DR HARRELLS, NC 28444 | AFLAC | $5 | — | $5 | 0.01% |
| LAUREN E SKINNER3 Filed as: LAUREN E SINNER | 1225 NORRIS ST RALEIGH, NC 27604 | AFLAC | $4 | — | $4 | 0.01% |
| GORDON K VANN3 | 2156 WESLEY LN GREENVILLE, NC 27858 | AFLAC | $3 | — | $3 | 0.01% |
| LARA K GRANDE3 | 117 MORNING MIST LN FRANKLIN, TN 37064 | AFLAC | $2 | — | $2 | 0.00% |
| MARY LEE NICHOLS3 | 2115 ARBOR VIEW CIR DIBERVILLE, MS 39540 | AFLAC | $2 | — | $2 | 0.00% |
| LINDA B CAMPBELL3 | 174 PALMETTO GREEN DR LONGS, SC 29568 | AFLAC | $2 | — | $2 | 0.00% |
| RUSSELL TINNEY3 | 3440 TORRINGTON WAY APT 7 STE 101 FAYETTEVILLE, VA 28314 | AFLAC | $2 | — | $2 | 0.00% |
| SEAN R HILDRETH3 | 434 TUCKER RD GRIMESLAND, NC 27837 | AFLAC | $1 | — | $1 | 0.00% |
| GREGORY D HILL3 | 16142 SWALLOWTAIL PL MIDLOTHIAN, VA 23113 | AFLAC | $1 | — | $1 | 0.00% |
| STEPHEN STRICKLAND3 | 147 WARREN DR ROANOKE RAPIDS, NC 27870 | AFLAC | $1 | — | $1 | 0.00% |
| DUANE A ADAMS3 | 11520 NUCKOLS RD STE 103 GLEN ALLEN, VA 23059 | AFLAC | $1 | — | $1 | 0.00% |
| ALFRED E DEVINE3 | 324 DEVINE WAY SILER CITY, NC 27344 | AFLAC | $1 | — | $1 | 0.00% |
| ERIC BROGAN3 Filed as: ERIC E MILLER | 728 MERCER PL HUNTERSVILLE, NC 28078 | AFLAC | $0 | — | $0 | 0.00% |
| MEGHAN MOFFATT LUCAS3 Filed as: MEGHAN M MILLER | 728 MERCER PL HUNTERSVILLE, NC 28078 | AFLAC | $0 | — | $0 | 0.00% |
| JAMES A SCOTT & SON INC3 | 2501 BLUE RIDGE RD STE 250 RALEIGH, NC 27607 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 8.20% |
| THOMPSON ALLEN INC3 | PO BOX 100 ROXBORO, NC 27573 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $552 | — | $552 | 1.80% |
| JAMES A SCOTT & SON INC3 | 2501 BLUE RIDGE RD STE 250 RALEIGH, NC 27607 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 8.21% |
| THOMPSON ALLEN INC3 | PO BOX 100 ROXBORO, NC 27573 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $440 | — | $440 | 1.79% |
| JAMES A SCOTT & SON INC3 | 2501 BLUE RIDGE RD STE 250 RALEIGH, NC 27607 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 12.07% |
| THOMPSON ALLEN INC3 | PO BOX 100 ROXBORO, NC 27573 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $666 | — | $666 | 2.93% |
| JAMES A SCOTT & SON INC3 | PO BOX 603438 CHARLOTTE, NC 28260 | STARMOUNT LIFE INSURANCE COMPANY | $2K | $704 | $2K | 16.96% |
| JAMES A SCOTT & SON INC3 | 2501 BLUE RIDGE RD, STE 250 RALEIGH, NC 27607 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $531 | — | $531 | 5.48% |
| THOMPSON ALLEN INC3 Filed as: THOMPSON-ALLEN, INC | PO BOX 100 ROXBORO, NC 27573 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $506 | — | $506 | 5.23% |
| JAMES A SCOTT & SON INC3 | 2501 BLUE RIDGE RD STE 250 RALEIGH, NC 27607 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $820 | — | $820 | 12.42% |
| THOMPSON ALLEN INC3 | PO BOX 100 ROXBORO, NC 27573 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $171 | — | $171 | 2.59% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ACCURISK SOLUTIONS BROKER | Insurance agents and brokers Service code 22 | 10 S. LASALLE ST, #2350 CHICAGO, IL 60603 | $246K |
| FLUME HEALTH EIN 82-4131029 CLAIMS PROCESSING | Claims processing Service code 12 | — | $128K |
| JAMES A. SCOTT & SON, INC. BROKER | Insurance agents and brokers Service code 22 | 1301 OLD GRAVES MILL ROAD LYNCHBURG, VA 24502 | $30K |
| THOMPSON-ALLEN INSURANCE BROKER | Insurance agents and brokers Service code 22 | PO BOX 100 ROXBORO, NC 27573 | $14K |
| QBE INSURANCE CORPORATION BROKER | Insurance agents and brokers Service code 22 | 1 QBE WAY SUN PRAIRIE, WI 53596 | $14K |
| SKYWARD (FKA HIIG) BROKER | Insurance agents and brokers Service code 22 | 8001 VILLA PARK DRIVE HENRICO, VA 23228 | $178 |
| NETWORK ACCESS BROKER | Insurance agents and brokers Service code 22 | 4580 MCKNIGHT RD PITTSBURGH, PA 15237 | -$1 |
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 | 185 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 189 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | STARMOUNT LIFE INSURANCE COMPANY | 139 | $14K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 197 | $10K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 187 | $7K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 104 | $25K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 81 | $31K |
| Other(3 contracts, 2 carriers) | AFLAC | 187 | $73K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 197 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.