| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PAYENTRY FINANCIAL SERVICES INC.3 | 19701 BETHEL CHURCH RD STE 103 PMB 320 CORNELIUS, NC 28031 | DELTA DENTAL OF NORTH CAROLINA | $9K | — | $9K | 12.78% |
| PAYENTRY FINANCIAL SERVICES INC.3 | 19701 BETHEL CHURCH RD STE 103 PMB 320 CORNELIUS, NC 28031 | VISION SERVICE PLAN | $871 | — | $871 | 6.51% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP | 5110 N 40TH ST STE 234 PHOENIX, AZ 85018 | VISION SERVICE PLAN | $671 | — | $671 | 5.02% |
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 | 107 | 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) | 107 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 90 | $569K |
| Dental | DELTA DENTAL OF NORTH CAROLINA | 218 | $70K |
| Vision | VISION SERVICE PLAN | 80 | $13K |
| Life insurance | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | 107 | $925 |
| Short-term disability | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | 107 | $925 |
| Stop-loss / reinsurancereinsurance | AETNA LIFE INSURANCE COMPANY | 90 | $569K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 218 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.