| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LISA L. HAMLETT3 Filed as: LISA L. HAMLET | 100 NORTH MAIN STREET WINSTON-SALEM, NC 27105 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $42K | $500 | $42K | 5.06% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 203508 DALLAS, TX 75320 | AETNA LIFE INSURANCE COMPANY | $9K | $91 | $9K | 11.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 203510 DALLAS, TX 75320 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $11K | — | $11K | 15.61% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 100 NOTH MAIN STREET, 10TH FLOOR WINSTON-SALEM, NC 27101 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $1K | — | $1K | 10.63% |
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 | 135 | 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) | 135 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 198 | $833K |
| Dental | AETNA LIFE INSURANCE COMPANY | 200 | $79K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 169 | $13K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 135 | $74K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 135 | $74K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 135 | $74K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 198 | $833K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 135 | $74K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 200 | — |
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.