| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLEGACY BENEFIT SOLUTIONS LLC3 Filed as: ALLEGACY BENEFIT SOLUTIONS | PO BOX 25172 WINSTON SALEM, NC 271145172 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | $0 | $5K | 1.73% |
| ALLEGACY BENEFIT SOLUTIONS LLC3 Filed as: ALLEGACY BENEFIT SOLUTIONS | PD BOX 25172 WINSTON SALEM, NC 271145172 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $123K | $0 | $123K | 57.42% |
| ALLEGACY BENEFIT SOLUTIONS LLC3 Filed as: ALLEGACY BENEFIT SOLUTIONS | PO BOX 25172 WINSTON-SALEM, NC 271145172 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $11K | $1K | $13K | 6.77% |
| ALLEGACY BENEFIT SOLUTIONS LLC3 Filed as: ALLEGACY BENEFIT SOLUTIONS | PO BOX 25172 WINSTON-SALEM, NC 271145172 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $332 | $7K | 15.75% |
| ALLEGACY BENEFIT SOLUTIONS LLC3 Filed as: ALLEGACY BENEFIT SOLUTIONS | PO BOX 25172 WINSTON-SALEM, NC 271145172 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $842 | $0 | $842 | 3.13% |
| JBA BENEFITS OF THE CAROLINAS LLC3 Filed as: JBA BENEFITS OF THE CAROLINAS | 1691 WESTBROOK DR WINSTON-SALEM, NC 27103 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $503 | $0 | $503 | 1.87% |
| ALLEGACY BENEFIT SOLUTIONS LLC3 Filed as: ALLEGACY BENEFIT SOLUTIONS | PO BOX 25172 WINSTON-SALEM, NC 271145172 | HARTFORD LIFE AND ACCIDENT | $603 | $0 | $603 | 15.01% |
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 | 272 | 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) | 272 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 526 | $214K |
| Dental | RELIANCE STANDARD LIFE INSURANCE COMPANY | 631 | $274K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 379 | $27K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 303 | $233K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 303 | $189K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 303 | $189K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 526 | $214K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 526 | $214K |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 355 | $237K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 631 | — |
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.