| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 4819 EMPEROR BLVD, STE 200 DURHAM, NC 27703 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $60K | $744 | $61K | 2.25% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 W GOLF RD 4TH FLOOR ROLLING MEADOWS, IL 60008 | DELTA DENTAL OF NORTH CAROLINA | $20K | — | $20K | 10.05% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 4819 EMPEROR BLVD STE 200 DURHAM, NC 27703 | HARTFORD LIFE AND ACCIDENT | $15K | — | $15K | 10.69% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP | 4611 UNIVERSITY DR DURHAM, NC 27702 | HARTFORD LIFE AND ACCIDENT | — | $10K | $10K | 7.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | HARTFORD LIFE AND ACCIDENT | — | $37 | $37 | 0.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 4819 EMPEROR BLVD STE 200 DURHAM, NC 27703 | EYEMED VISION CARE OBO THE FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 8.59% |
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 | 141 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 148 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 369 | $2.7M |
| Dental | DELTA DENTAL OF NORTH CAROLINA | 380 | $200K |
| Vision | EYEMED VISION CARE OBO THE FIDELITY SECURITY LIFE INSURANCE COMPANY | 283 | $21K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 168 | $137K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 168 | $137K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 168 | $137K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 369 | $2.7M |
| Other | HARTFORD LIFE AND ACCIDENT | 168 | $137K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 380 | — |
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.