| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DAVID GOOGE3 Filed as: DAVID W GOOGE | 723 COLISEUM DRIVE SUITE 202 WINSTON-SALEM, NC 27106 | AETNA LIFE INSURANCE CO. | $16K | — | $16K | 9.18% |
| GLENN ZIMMERMAN INC3 Filed as: GLENN ZIMMERMAN INC. | 1510 HIGH ROCK ROAD GIBSONVILLE, NC 27249 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11K | $3K | $14K | 9.89% |
| SALEM BENEFITS GROUP INC3 Filed as: SALEM BENEFITS GROUP INC. | C/O SALEM BENEFITS GROUP INC. WINSTON-SALEM, NC 27103 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8K | — | $8K | 5.85% |
| WORKSITE BENEFIT SERVICES3 | 4317 NEW BRIGHTON DRIVE APEX, NC 27539 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 1.05% |
| DONNA N DWYER3 | 1540 WESTBROOK PLAZA DRIVE WINSTON-SALEM, NC 27103 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $620 | $581 | $1K | 0.84% |
| HOWARD HOROWITZ3 | 2610 ALCOTT STREET CARMEL, IN 46032 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $320 | $116 | $436 | 0.31% |
| PHIL COLEMAN3 | 18908 RIVERWIND LANE DAVIDSON, NC 28036 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $335 | — | $335 | 0.23% |
| JOHN J SWIDERSKI3 | 3316 SINGLELEAF LANE RALEIGH, NC 27616 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $187 | $1 | $188 | 0.13% |
| PETER MICHAEL FOLEY JR3 Filed as: PETER MICHAEL FOLEY | 150 PAMPLICO LANE MOORESVILLE, NC 28117 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $137 | — | $137 | 0.10% |
| TODD GERALD GECEWICZ3 Filed as: TODD G GECEWICZ | 6110 CREEK GLEN WAY APEX, NC 27502 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $70 | — | $70 | 0.05% |
| PARRISH J PEACHEE3 | 201 W 103RD STREET INDIANAPOLIS, IN 46290 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $25 | $5 | $30 | 0.02% |
| GAIL STEWART GOLD3 | 11919 SUNFLOWER LANE RICHMOND, VA 23236 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $29 | — | $29 | 0.02% |
| MELODIE M MCDANIEL3 | 288 BACKWOODS TRAIL CANTON, NC 28716 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $23 | — | $23 | 0.02% |
| LEON MARTIN3 | 1520 MARTIN STREET WINSTON-SALEM, NC 27103 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.00% |
| BB&T INSURANCE SERVICES, INC.3 Filed as: BB&T INSURANCE SERVICES INC. | 414 GALLIMORE DAIRY ROAD GREENSBORO, NC 27409 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.00% |
| BENEFITS COUNT INC3 Filed as: BENEFITS COUNT INC. | 1401 CHRISTMAS COURT RALEIGH, NC 27604 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.00% |
| KJELL T TERRELL3 | 327 GOLF COURSE DRIVE RALEIGH, NC 27610 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.00% |
| RONALD LEE MARTIN3 | 1963 HAVEN ROAD GREENSBORO, NC 27410 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| PATRICIA L CARON3 | 190 TESUQUE VILLAGE ROAD SANTA FE, NM 87506 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| INSYNC BENEFITS INC3 Filed as: INSYNC BENEFITS INC. | PO BOX 1474 CORNELIUS, NC 28031 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| GOOGE FINANCIAL SERVICES, INC.3 | 723 COLISEUM SUITE 202 WINSTON-SALEM, NC 27106 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 10.00% |
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 | 638 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 638 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 638 | $185K |
| Short-term disability(3 contracts, 3 carriers) | AETNA LIFE INSURANCE CO. | 638 | $328K |
| Long-term disability(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 638 | $185K |
| Other(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 638 | $185K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 638 | — |
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.