| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 1012 EAST WALL STREET MOUNT PLEASANT, SC 29464 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $43K | $0 | $43K | 10.83% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $8K | $8K | 1.96% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $0 | $6K | 1.57% |
| D.L. DAVIS & COMPANY INC.3 Filed as: D L DAVIS & COMPANY, INC. | 1315 SOUTH MAIN STREET WINSTON SALEM, NC 27127 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 3.63% |
| NICHOLAS B. GAVALAS3 | 799 CREEKSIDE DRIVE MOUNT PLEASANT, SC 29464 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $120 | — | $120 | 0.31% |
| TRIAD BENEFITS GROUP INC3 Filed as: TRIAD BENEFITS GROUP, INC. | 200 DOLLY LANE WINSTON SALEM, NC 27107 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $716 | $501 | $1K | 3.79% |
| JAMES J PHARES3 Filed as: JAMES J. PHARES | 2037 AZALEE LANE SUMMERVILLE, SC 29483 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $947 | $113 | $1K | 3.30% |
| BENEFIT COUNT I, INC.3 | 1401 CHRISTMAS COURT RALEIGH, NC 27604 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $640 | $0 | $640 | 2.00% |
| SUE S. WARDEN3 | PO BOX 310 ADVANCE, NC 27006 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $445 | $0 | $445 | 1.39% |
| ELIZABETH KOENIG3 Filed as: ELIZABETH KOENIG & OTHER AGENTS | PO BOX 239 PISGAH FOREST, NC 28768 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $316 | $53 | $369 | 1.15% |
| BENEFIT COUNT LI INC3 Filed as: BENEFIT COUNT II, INC. | 1401 CHRISTMAS COURT RALEIGH, NC 27604 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $268 | $84 | $352 | 1.10% |
| ARTHUR WAYNE JORDAN JR3 | 514 OAKWOOD AVENUE RALEIGH, NC 27601 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $250 | $6 | $256 | 0.80% |
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 | 340 | 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) | 340 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 373 | $436K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 373 | $397K |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 373 | $480K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 373 | — |
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.