| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | DELTA DENTAL OF NORTH CAROLINA | $6K | — | $6K | 9.17% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN LLC | PO BOX 32135 RICHMOND, VA 23294 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $166 | $166 | 0.88% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 12748 ROANOKE, VA 24028 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $93 | $93 | 0.49% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF NORTH CAR EIN 56-0894904 HEALTH PROVIDER | Direct payment from the plan; Contract Administrator; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Participant communication Service code 12 | 5901 CHAPEL HILL RD DURHAM, NC 277073346 | $68K |
| DAVID ROMERO BROKER | Insurance agents and brokers Service code 22 | 6230 FAIRVIEW ROAD STE 230 CHARLOTTE, NC 28210 | $24K |
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 | 181 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 182 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF NORTH CAROLINA | 224 | $65K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 181 | $19K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 181 | $19K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 224 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.