| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SERVICES USA | 6100 FAIRVIEW RD STE 1400 CHARLOTTE, NC 282103293 | METROPOLITAN LIFE INSURANCE COMPANY | $47K | $27 | $47K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SERVICES USA INC | 1018 W 9TH AVE KING OF PRUSSIA, PA 194061225 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $18K | $18K | 1.93% |
| LISA L. HAMLETT3 Filed as: LISA HAMLETT | 100 N MAIN ST MAIL CODE NC6952 WINSTON-SALEM, NC 27105 | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | $128K | — | $128K | 14.67% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO | 150 N. MICHIGAN AVE CHICAGO, IL 60601 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $70K | — | $70K | 9.96% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | P O BOX 203066 DALLAS, TX 75320 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $0 | $14K | $14K | 1.96% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO | 150 N. MICHIGAN AVE CHICAGO, IL 60601 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $38K | — | $38K | 9.95% |
| WELLS FARGO INSURANCE SERVICES4 Filed as: WELLS FARGO INSURANCE SERVICES USA | P O BOX 203066 DALLAS, TX 75320 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $0 | $7K | $7K | 1.94% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO | 150 N. MICHIGAN AVE CHICAGO, IL 60601 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $32K | — | $32K | 9.99% |
| WELLS FARGO INSURANCE SERVICES4 Filed as: WELLS FARGO INSURANCE SERVICES USA | P O BOX 203066 DALLAS, TX 75320 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $0 | $6K | $6K | 1.98% |
| WELLS FARGO INSURANCE SERVICES3 | P O BOX 203510 DALLAS, TX 753203510 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $19K | — | $19K | 9.91% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| FLORES AND ASSOCIATES EIN 56-1542307 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $34K |
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 | 1,856 | 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) | 1,856 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 2,572 | $875K |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 2,739 | $1.8M |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 2,173 | $195K |
| Life insurance | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 2,195 | $384K |
| Short-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 1,091 | $705K |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 1,075 | $317K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 2,572 | $875K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 2,572 | $875K |
| Other | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 2,195 | $384K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,739 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.