| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC. | TWO PIERCE PLACE 14TH FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $33K | $0 | $33K | 11.72% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $3K | $3K | 1.01% |
| 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 | $3K | $0 | $3K | 3.60% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE 14TH FLOOR ITASCA, IL 60143 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 2.17% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $4K | $0 | $4K | 13.65% |
| CAMPBELL WILLIAM TAYLOR II3 | 5080 NOTTINGHAM PLACE LANE WINSTON SALEM, NC 27106 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $6 | $0 | $6 | 0.02% |
| D.L. DAVIS & COMPANY INC.3 Filed as: DAVIS DERRICK LEE | 1315 SOUTH MAIN STREET WINSTON SALEM, NC 27127 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $6 | $0 | $6 | 0.02% |
| NICHOLAS B. GAVALAS3 | 799 CREEKSIDE DRIVE MOUNT PLEASANT, SC 29464 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $2 | $0 | $2 | 0.01% |
| BERTRAND HUDNALL3 Filed as: BERTRAND HUDNALL III | 40 CALHOUN STREET CHARLESTON, SC 29401 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
| JAMES J PHARES3 Filed as: JAMES J. PHARES | 2037 AZALEE LANE SUMMERVILLE, SC 29483 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $953 | $3K | 17.13% |
| BENEFITS COUNT INC3 Filed as: BENEFITS COUNT I INC. | 2487 RIVERWOOD DRIVE LEWISVILLE, NC 27023 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $155 | $1K | 9.34% |
| SUE S. WARDEN3 | 1111 SOUTH MARSHALL STREET WINSTON-SALEM, NC 27101 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | 8.11% |
| ARTHUR WAYNE JORDAN JR3 Filed as: ARTHUR WAYNE JORDAN, JR. | 514 OAKWOOD AVENUE RALEIGH, NC 27601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $432 | $170 | $602 | 4.06% |
| ROBERT P BARBATI3 Filed as: ROBERT P. BARBATI AND OTHER AGENTS | 1078 N. SHADOW DRIVE MOUNT PLEASANT, SC 29464 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $450 | $145 | $595 | 4.02% |
| BENEFITS COUNT INC3 Filed as: BENEFITS COUNT INC. | 1401 CHRISTMAS COURT RALEIGH, NC 27604 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $241 | $167 | $408 | 2.75% |
| PAUL STANLEY JR3 Filed as: PAUL STANLEY JR. | 880 JOHNNY DODD BOULEVARD MOUNT PLEASANT, SC 29464 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $119 | $84 | $203 | 1.37% |
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 | 248 | 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) | 248 | 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 | 275 | $311K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 275 | $279K |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 275 | $367K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 275 | — |
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.