| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 303395946 | PRINCIPAL LIFE INSURANCE | $10K | $762 | $11K | 11.46% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 400 GALLERIA PARKWAY ATLANTA, GA 30339 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $447 | $5K | 14.69% |
| JOHN J SWIDERSKI3 | 3316 SINGLELEAF LANE RALEIGH, NC 27616 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $2K | $5K | 14.29% |
| TIMOTHY J SWIDERSKI3 | 3316 SINGLELEAF LANE RALEIGH, NC 27616 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $531 | $2K | 6.33% |
| JOHN MATTHEW MUMPOWER3 | 7211 WALKING HORSE COURT WILMINGTON, NC 28411 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $721 | $2 | $723 | 2.03% |
| LEON MARTIN3 | 1520 MARTINE STREET WINSTON SALEM, NC 27103 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $131 | — | $131 | 0.37% |
| HARRIS WINTERS Filed as: HARRIS STEPHEN WINTERS | 4004 KNICKERBOCKER PARKWAY RALEIGH, NC 27612 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $70 | — | $70 | 0.20% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: CHARLES W MARSH | 702 WYNBROOK SQUARE LANE WINSTON SALEM, NC 27103 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $51 | — | $51 | 0.14% |
| FRED RAAB3 | 2904 DUNHAVEN DR GARNER, NC 27529 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.01% |
| GLENN ZIMMERMAN INC3 Filed as: GLENN PIERCE | 4928 LINKSLAND DR HOLLY SPRINGS, NC 27540 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.01% |
| ROBERT P MCFARLAND3 | 6739 MOUNTAIN MAJESTY WAY HUNTERSVILLE, NC 28078 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.01% |
| PHIL COLEMAN3 | 18908 RIVERWIND LANE DAVIDSON, NC 28036 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.01% |
| DONNA N DWYER3 | 1540 WESTBROOK PLAZA DR WINSTON SALEM, NC 27103 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.01% |
| ALLAN VISSER3 | 3790 HIGH POINT ROAD WINSTON SALEM, NC 27107 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | — | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DIGITAL SERVICES, INC. EIN 58-2522668 CONSULTING | Consulting (general) Service code 16 | 200 GALLERIA PKY STE 1950 ATLANTA, GA 30339 | $30K |
| FLORES AND ASSOCIATES EIN 56-1542307 COBRA ADMINISTRATION | Contract Administrator Service code 13 | 1218 S. CHURCH STREET CHARLOTTE, NC 28203 | $1K |
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 | 117 | 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) | 117 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 186 | $790K |
| Dental | PRINCIPAL LIFE INSURANCE | 234 | $96K |
| Life insurance | PRINCIPAL LIFE INSURANCE | 234 | $96K |
| Short-term disability | PRINCIPAL LIFE INSURANCE | 234 | $96K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 234 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.