| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PAUL BRUNO3 | 8922 ABRELL WALK COURT CHARLOTTE, NC 28226 | BLUECROSS BLUESHIELD OF NORTH CAROLINA | $1K | $0 | $1K | 0.05% |
| SCOTT ANDERSON3 | 100 SUMMIT LAKE DRIVE, SUITE 400 VALHALLA, NY 10595 | BLUECROSS BLUESHIELD OF NORTH CAROLINA | $1K | $0 | $1K | 0.05% |
| ROBERT KENNEDY3 | 100 SUMMIT LAKE DRIVE, SUITE 400 VALHALLA, NY 10595 | BLUECROSS BLUESHIELD OF NORTH CAROLINA | $229 | $0 | $229 | 0.01% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62819 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $22K | $0 | $22K | 15.76% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP SERVICES, LLC | 4611 UNIVERSITY DRIVE DURHAM, NC 27702 | HARTFORD LIFE AND ACCIDENT | $0 | $11K | $11K | 7.66% |
| USI INSURANCE SERVICES LLC3 | ENTERPRISE LICENSING CENTER SEATTLE, WA 98101 | HARTFORD LIFE AND ACCIDENT | $0 | $9K | $9K | 6.53% |
| LOCKTON COMPANIES, LLC3 | 6000 FELDWOOD ROAD COLLEGE PARK, GA 30349 | HARTFORD LIFE AND ACCIDENT | $7K | $0 | $7K | 5.39% |
| RUTH A ANDERSON4 Filed as: RUTH A. ANDERSON | 331 SOUTH FAYETTEVILLE STREET CLAYTON, NC 27520 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $2K | $0 | $2K | 31.93% |
| STOVALL & ASSOCIATES INC.4 Filed as: STOVALL & ASSOCIATES, INC. | 114 MARITIME COURT CHOCOWINITY, NC 27817 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $500 | $0 | $500 | 10.11% |
| PATSY HOLLAND4 | 525 BAKER CROSSROAD ROAD REIDSVILLE, NC 27320 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $97 | $0 | $97 | 1.96% |
| JEREMIAH A. NORTHROP4 | PO BOX 12 TALLEVAST, FL 34270 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $29 | $0 | $29 | 0.59% |
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 | 225 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 10 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 237 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF NORTH CAROLINA | 445 | $2.5M |
| Dental | BLUECROSS BLUESHIELD OF NORTH CAROLINA | 445 | $2.5M |
| Vision | BLUECROSS BLUESHIELD OF NORTH CAROLINA | 445 | $2.5M |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 222 | $138K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 222 | $138K |
| Prescription drug | BLUECROSS BLUESHIELD OF NORTH CAROLINA | 445 | $2.5M |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 222 | $143K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 445 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.