| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SUZANNE K. JOHNSON3 | 5955 CARNEGIE BOULEVARD, SUITE 150 CHARLOTTE, NC 28209 | NORTHWESTERN MUTUAL | $14K | $3K | $17K | 16.49% |
| RICHARD WORRELL LLC3 Filed as: RICHARD WORRELL, LLC | 6235 MORRISON BOULEVARD CHARLOTTE, NC 28211 | NORTHWESTERN MUTUAL | $3K | $365 | $3K | 3.28% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 115 CENTRAL ISLAND STREET SUITE 100 CHARLESTON, SC 29492 | AMERITAS LIFE INSURANCE CORPORATION | $8K | $0 | $8K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 21ST FLOOR ROLLING MEADOWS, IL 60008 | AMERITAS LIFE INSURANCE CORPORATION | $0 | $604 | $604 | 0.74% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 115 CENTRAL ISLAND STREET SUITE 100 CHARLESTON, SC 29492 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $11K | $0 | $11K | 16.32% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 400 MIDLANTIC DRIVE MOUNT LAUREL, NJ 08054 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $600 | — | $600 | 0.90% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $30 | $30 | 0.04% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $5 | $5 | 0.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, SUITE 1000 ROLLING MEADOWS, IL 60008 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $1K | $0 | $1K | 9.83% |
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 | 170 | 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) | 170 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AMERITAS LIFE INSURANCE CORPORATION | 213 | $81K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 157 | $11K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 170 | $67K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 170 | $67K |
| Long-term disability | NORTHWESTERN MUTUAL | 42 | $104K |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 170 | $67K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 213 | — |
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.