| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL,INC | 2975 REGENT BLVD IRVING, TX 75063 | DELTA DENTAL OF NORTH CAROLINA | $51K | — | $51K | 4.59% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO | 150 N. MICHIGAN AVE CHICAGO, IL 60601 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $82K | — | $82K | 9.16% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | P O BOX 203066 DALLAS, TX 75320 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $16K | $16K | 1.72% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO | 150 N. MICHIGAN AVE CHICAGO, IL 60601 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $45K | — | $45K | 9.17% |
| WELLS FARGO INSURANCE SERVICES4 Filed as: WELLS FARGO INSURANCE SERVICES USA | P O BOX 203066 DALLAS, TX 75320 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $9K | $9K | 1.73% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO | 150 N. MICHIGAN AVE CHICAGO, IL 60601 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $36K | — | $36K | 8.97% |
| WELLS FARGO INSURANCE SERVICES4 Filed as: WELLS FARGO INSURANCE SERVICES USA | P O BOX 203066 DALLAS, TX 75320 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $7K | $7K | 1.72% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 100 N MAIN STREET WINSTON SALEM, NC 27150 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $25K | — | $25K | 10.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL,INC | 100 N MAIN ST WINSTON SALEM, NC 27150 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $333 | $6K | 7.58% |
| DIRECTPATH, LLC3 | 120 18TH ST S STE 102 BIRMINGHAM, AL 35233 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $25 | — | $25 | 0.03% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL,INC | 100 N MAIN ST WINSTON SALEM, NC 27150 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $781 | $4K | 5.68% |
| DIRECTPATH, LLC3 | 120 18TH ST S STE 102 BIRMINGHAM, AL 35233 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 2.07% |
| EDWARD J WILLIAMS3 Filed as: EDWARD WILLIAMS | 5400 GLENWOOD AVE STE G11 RALEIGH, NC 27612 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $277 | — | $277 | 0.38% |
| MICHAEL L COUSINS3 Filed as: MICHAEL COUSINS | PO BOX 327 GARNER, NC 27529 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $268 | — | $268 | 0.37% |
| MUNICIPAL BENEFITS LLC3 Filed as: MUNICIPAL BENEFITS, INC | 1053 BULLARD CT RALEIGH, NC 27615 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $205 | — | $205 | 0.28% |
| LISA L. HAMLETT3 Filed as: LISA HAMLETT | 100 N MAIN ST WINSTON-SALEM, NC 27105 | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | $74K | — | $74K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| FLORES AND ASSOCIATES EIN 56-1542307 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $40K |
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 | 1,978 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 12 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,990 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 3,229 | $0 |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF NORTH CAROLINA | 3,338 | $1.1M |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 2,823 | $248K |
| Life insurance(2 contracts, 2 carriers) | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 2,818 | $566K |
| Short-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 1,271 | $899K |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 1,231 | $399K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 3,229 | $0 |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 3,229 | $0 |
| Other(3 contracts, 3 carriers) | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 2,818 | $649K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,338 | — |
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."
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.