| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AUGUSTINE A OLALERE3 Filed as: AUGUSTINE A. OLETERE | 741 JOHNNIE DODDS BLVD MT PLEASANT, SC 29464 | RELIASTAR LIFE INSURANCE COMPANY | $14K | — | $14K | 7.20% |
| CREATIVE WORKSITE SOLUTIONS LLC3 Filed as: CREATIVE WORKSITE SOLUTIONS, LLC | 3404 SALTERBACK CT 207 MT PLEASANT, SC 29466 | RELIASTAR LIFE INSURANCE COMPANY | $4K | — | $4K | 1.80% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| KATHY WOMACK EIN 58-2126333 EMPLOYEE | Participant communication; Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Employee (plan) Service code 15 | — | $114K |
| RENATE GRAY EIN 58-2126333 EMPLOYEE | Direct payment from the plan; Employee (plan); Recordkeeping and information management (computing, tabulating, data processing, etc.); Participant communication Service code 15 | — | $104K |
| MILA MANAGED HEALTH CARE TRUST FUND AFFILIATED INSURANCE | Participant communication; Direct payment from the plan; Claims processing; Insurance services Service code 12 | 111 BROADWAY, 5TH FLOOR NEW YORK, NY 10006 | $71K |
| JUDY BALLARD EIN 58-2126333 EMPLOYEE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan; Participant communication; Employee (plan) Service code 15 | — | $50K |
| MARLENE PAK-SMITH EIN 58-2126333 EMPLOYEE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan; Employee (plan) Service code 15 | — | $50K |
| TJS DEEMER DANA LLP EIN 58-2663273 AUDITOR | Direct payment from the plan; Accounting (including auditing) Service code 10 | P O BOX 9706 SAVANNAH, GA 31412 | $24K |
| J&M EXECUTIRE LEASING EIN 45-4804558 VENDOR | Copying and duplicating; Direct payment from the plan Service code 36 | — | $9K |
| DUKE ENERGY PROGRESS UTILITY VENDOR | Other services; Direct payment from the plan Service code 49 | P O BOX 1771 RALEIGH, NC 27602 | $6K |
| INTNL FOUNDATION OF EMPLOYEE BENEFI BENEFIT INFO PROVIDER | Direct payment from the plan; Other services Service code 49 | P O BOX 68-9952 MILWAUKEE, WI 53268 | $6K |
| TIME WARNER CABLE UTILITY VENDOR | Direct payment from the plan; Other services Service code 49 | P O BOX 70872 CHARLOTTE, NC 28272 | $6K |
| FINDLEY DAVIS EIN 34-1213174 ACTUARY | Recordkeeping and information management (computing, tabulating, data processing, etc.); Participant communication; Direct payment from the plan; Actuarial Service code 11 | 800 GREEN VALLEY ROAD GREENSBORO, NC 27408 | $5K |
| LINDA SIMMONS BUILDING CUSTODIAN | Other services; Direct payment from the plan Service code 49 | 612 SOUTH 17TH STREET WILMINGTON, NC 28402 | $5K |
| BLANKS BROS HOME IMPROVEMENT COMPAN CONSTRUCTION CONTRACTOR | Other services; Direct payment from the plan Service code 49 | 226 WALLINGTON ROAD WILMINGTON, NC 28409 | $5K |
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 | 262 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 217 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 479 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 457 | $195K |
| Other | RELIASTAR LIFE INSURANCE COMPANY | 457 | $195K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 457 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.