| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 21ST FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $35K | $0 | $35K | 8.55% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | $0 | $10K | 2.52% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $4K | $4K | 0.96% |
| D.L. DAVIS & COMPANY INC.3 Filed as: D. L. DAVIS AND COMPANY, INC. | 1315 SOUTH MAIN STREET WINSTON SALEM, NC 27127 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $0 | $3K | 3.51% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $477 | $0 | $477 | 0.64% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 21ST FLOOR ITASCA, IL 60143 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $409 | $0 | $409 | 0.55% |
| HUDNALL BERTRAND III3 | 40 CALHOUN STREET, SUITE 310 CHARLESTON, SC 29401 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $4 | $0 | $4 | 0.01% |
| NICHOLAS B. GAVALAS3 | 799 CREEKSIDE DRIVE MOUNT PLEASANT, SC 29464 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $3 | $0 | $3 | 0.01% |
| JAMES J PHARES3 Filed as: JAMES J. PHARES | 2037 AZALEE LANE SUMMERVILLE, SC 29483 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $431 | $2K | 6.50% |
| SUE S. WARDEN3 | 1111 SOUTH MARSHALL STREET WINSTON-SALEM, NC 27101 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | 4.68% |
| BENEFIT COUNT I, INC.3 | 248 RIVERWOOD DRIVE LEWISVILLE, NC 27023 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | 4.44% |
| ARTHUR WAYNE JORDAN JR3 Filed as: ARTHUR WAYNE JORDAN, JR. | 514 OAKWOOD AVENUE RALEIGH, NC 27601 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $423 | $119 | $542 | 2.05% |
| ADV BENEFIT SYS INC & OTHER AGENTS3 Filed as: ADV. BEN. SYS. INC AND OTHER AGENTS | 145 RIVER LANDING DRIVE DANIEL ISLAND, SC 29492 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $276 | $54 | $330 | 1.25% |
| BENEFIT COUNT LI INC3 Filed as: BENEFIT COUNT II, INC. | 1401 CHRISTMAS COURT RALEIGH, NC 27604 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $253 | $66 | $319 | 1.21% |
| PAUL STANLEY JR3 Filed as: PAUL STANLEY, JR. | 5264 INTERNATIONAL BOULEVARD NORTH CHARLESTON, SC 29418 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $73 | $77 | $150 | 0.57% |
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 | 352 | 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) | 352 | 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 | 352 | $456K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 352 | $409K |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 352 | $510K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 352 | — |
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.