| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HARDIN, DONALD R3 | 100 N TRYON ST STE 3400 CHARLOTTE, NC 28202 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $75K | $828 | $76K | 2.98% |
| MERCER HEALTH AND BENEFITS, LLC3 | 17901 VON KARMAN AVE IRVINE, CA 92614 | AMERITAS LIFE INSURANCE CORP. | $19K | — | $19K | 8.31% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: SENN DUNN A MARSH & MCLENNAN AGENCY | 3625 N ELM ST #200 GREENSBORO, NC 27455 | AMERITAS LIFE INSURANCE CORP. | -$66 | — | -$66 | -0.03% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | RELIASTAR LIFE INSURANCE COMPANY | $19K | — | $19K | 12.73% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP SERVICES, LLC | PO BOX 2291 DURHAM, NC 277022291 | RELIASTAR LIFE INSURANCE COMPANY | — | $5K | $5K | 3.64% |
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 | 209 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 219 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 446 | $2.5M |
| Dental | AMERITAS LIFE INSURANCE CORP. | 468 | $231K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 468 | $231K |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 172 | $147K |
| Short-term disability | RELIASTAR LIFE INSURANCE COMPANY | 172 | $147K |
| Long-term disability | RELIASTAR LIFE INSURANCE COMPANY | 172 | $147K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 446 | $2.5M |
| Other | RELIASTAR LIFE INSURANCE COMPANY | 172 | $147K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 468 | — |
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.