| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CHARLES D KENNEDY JR3 | 4020 WEST CHASE BLVD FLOOR 2 RALEIGH, NC 27607 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $124K | — | $124K | 2.91% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 333 N GREENE ST STE 101 GREENSBORO, NC 27401 | PRINCIPAL LIFE INSURANCE COMPANY | $22K | — | $22K | 6.02% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP | PO BOX 2291 STE 101 DURHAM, NC 27702 | PRINCIPAL LIFE INSURANCE COMPANY | $18K | — | $18K | 5.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 300 N LASALLE ST 17TH FLOOR CHICAGO, IL 60654 | PRINCIPAL LIFE INSURANCE COMPANY | — | $15K | $15K | 4.20% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 3510 N CAUSEWAY BLVD STE 300 METAIRIE, LA 70002 | USABLE LIFE | $379 | — | $379 | 5.62% |
| MOSAIC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $337 | — | $337 | 5.00% |
| BANYAN CONSULTING GROUP INC3 | 333 N GREENE ST SUITE 101 GREENSBORO, NC 27401 | USABLE LIFE | $296 | — | $296 | 4.39% |
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 | 229 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 231 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 505 | $4.3M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 479 | $365K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 479 | $365K |
| Life insurance(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 479 | $371K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 479 | $365K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 479 | $365K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 505 | $4.3M |
| Other | USABLE LIFE | 207 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 505 | — |
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.