| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CIGNA5 Filed as: CIGNA HEALTH AND LIFE INSURANCE COM | — | CIGNA HEALTH & LIFE INSURANCE CO | — | $157K | $157K | 27.88% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES, INC. | — | CIGNA HEALTH & LIFE INSURANCE CO | $55K | — | $55K | 9.72% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES | 1901 ROXBOROUGH RD STE 300 CHARLOTTE, NC 28211 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 7.73% |
| NFP INSURANCE SERVICES INC5 Filed as: NFP CORPORATE SERVICES, INC. | 1901 ROXBOROUGH RD STE 300 CHARLOTTE, NC 28211 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 3.02% |
| NFP INSURANCE SERVICES INC3 | 1250 S CAPITAL OF TEXAS HWY STE 600 WEST LAKE HILLS, TX 78746 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $555 | $555 | 0.93% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES INC | 1901 ROXBOROUGH RD STE 300 CHARLOTTE, NC 28211 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 5.99% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES | 1901 ROXBOROUGH RD STE 300 CHARLOTTE, NC 28211 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 4.00% |
| NFP INSURANCE SERVICES INC5 Filed as: NFP CORPORATE SERVICES | 1901 ROXBOROUGH RD STE 300 CHARLOTTE, NC 28211 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 3.27% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP INSURANCE SERVICES | 1250 S CAPITAL OF TEXAS HWY STE 600 WEST LAKE HILLS, TX 78746 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $548 | $548 | 1.00% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES | 1901 ROXBOROUGH RD STE 300 CHARLOTTE, NC 28211 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 8.01% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES | 1901 ROXBOROUGH RD STE 300 CHARLOTTE, SC 28211 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 4.27% |
| NFP INSURANCE SERVICES INC5 Filed as: NFP CORPORATE SERVICES | 1901 1901 ROXBOROUGH RD STE 300 CHARLOTTE, NC 28211 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 3.60% |
| NFP INSURANCE SERVICES INC3 | 1250 S CAPITAL OF TEXAS HWY STE 600 WEST LAKE HILLS, TX 78746 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $355 | $355 | 0.71% |
| NFP INSURANCE SERVICES INC5 Filed as: NFP CORPORATE SERVICES | 1901 ROXBOROUGH RD STE 300 CHARLOTTE, NC 28211 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 8.66% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES | 1901 CHARLOTTE, NC 28211 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 5.53% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES | 1901 ROXBOROUGH RD STE 300 CHARLOTTE, NC 28211 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 5.00% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP INSURANCE SERVICES | 1250 S CAPITAL OF TEXAS HWY STE 600 WEST LAKE HILLS, TX 78746 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $346 | $346 | 0.92% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES | 1901 ROXBOROUGH RD CHARLOTTE, NC 28211 | EYEMED | $2K | — | $2K | 10.72% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES | 1901 ROXBOROUGH RD STE 300 CHARLOTTE, NC 28211 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $513 | $513 | 3.39% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES INC | 1250 S CAPITAL OF TEXAS HWY STE 600 WEST LAKE HILLS, TX 78746 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $86 | $86 | 0.57% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES | 710 JOHNNIE DODDS BLVD MOUNT PLEASANT, SC 29464 | COLONIAL LIFE & ACCIDENT COMPANY | $1K | $40 | $1K | 10.23% |
| SHEALY BENEFITS SERVICES INC3 Filed as: SHEALY BENEFITS SERVICES, INC. | 215 HOGAN WAY LEXINGTON, SC 29072 | COLONIAL LIFE & ACCIDENT COMPANY | $721 | $427 | $1K | 8.38% |
| ERIN WIGGINS3 | 2036 TELFAIR WAY CHARLESTON, SC 29412 | COLONIAL LIFE & ACCIDENT COMPANY | $451 | $92 | $543 | 3.96% |
| LAURA MCCLUNG PLYLER3 Filed as: LAURA MCCLUNG PLYER | 547 BIMINI TWIST CIR LEXINGTON, SC 29072 | COLONIAL LIFE & ACCIDENT COMPANY | $436 | $35 | $471 | 3.44% |
| ADVANCED BENEFIT SYSTEM INC3 Filed as: ADVANCED BENEFIT SYSTEMS | 145 RIVER LANDING DR DANIEL ISLAND, SC 29492 | COLONIAL LIFE & ACCIDENT COMPANY | $109 | $65 | $174 | 1.27% |
| THE CLARK GROUP OF SC3 | 589 WINDMERE DR LEXINGTON, SC 29072 | COLONIAL LIFE & ACCIDENT COMPANY | $81 | $0 | $81 | 0.59% |
| NORTH FLORIDA BROKER SOLUTIONS LLC3 | 1550 HARRINGTON PARK DR JACKSONVILLE, SC 32225 | COLONIAL LIFE & ACCIDENT COMPANY | $4 | $1 | $5 | 0.04% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP | 710 JOHNNIE DODDS BLVD STE 100 MOUNT PLEASANT, SC 29464 | EDOC HOME | — | $2K | $2K | 16.95% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH & LIFE INSURANCE EIN 59-1031071 NONE | Non-monetary compensation; Other services; Float revenue; Participant communication; Contract Administrator; Direct payment from the plan; Named fiduciary; Claims processing Service code 12 | — | $19K |
| DELTA DENTAL OF MISSOURI EIN 43-0908349 NONE | Contract Administrator; Claims processing Service code 12 | — | $15K |
| FLORES & ASSOCIATES, LLC EIN 56-1542307 NONE | Account maintenance fees; Claims processing Service code 12 | PO BOX 31397 CHARLOTTE, NC 28231 | $11K |
| CIGNA | Named fiduciary; Other services; Claims processing; Direct payment from the plan; Non-monetary compensation; Participant communication; Float revenue; Contract Administrator Service code 12 | — | $0 |
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 | 316 | 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) | 316 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH & LIFE INSURANCE CO | 370 | $573K |
| Dental | CIGNA HEALTH & LIFE INSURANCE CO | 370 | $563K |
| Vision | EYEMED | 288 | $18K |
| Life insurance(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 318 | $106K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 253 | $50K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 319 | $59K |
| Prescription drug | CIGNA HEALTH & LIFE INSURANCE CO | 370 | $563K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 318 | $70K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 370 | — |
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.