| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WORTHAM SAN ANTONIO INC3 Filed as: JOHN ARMINIO | 4401 NORTHSIDE PARKWAY NW STE 800 ATLANTA, GA 30327 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $568 | — | $568 | 0.05% |
| MARSH & MCLENNAN AGENCY LLC3 | 4401 NORTHSIDE PARKWAY SUITE 800 ATLANTA, GA 303275282 | HARTFORD LIFE AND ACCIDENT | $12K | — | $12K | 11.69% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP SERVICES, LLC | 4611 UNIVERSITY DR DURHAM, NC 27702 | HARTFORD LIFE AND ACCIDENT | — | $6K | $6K | 6.04% |
| MARSH & MCLENNAN AGENCY LLC3 | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | HARTFORD LIFE AND ACCIDENT | $2K | — | $2K | 2.38% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP SERVICES, LLC | 4611 UNIVERSITY DR DURHAM, NC 27702 | HARTFORD LIFE AND ACCIDENT | — | $989 | $989 | 0.96% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES LLC | PO BOX 896620 CHARLOTTE, NC 282896620 | HARTFORD LIFE AND ACCIDENT | — | $419 | $419 | 0.41% |
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 | 191 | 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) | 191 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 300 | $1.2M |
| Dental | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 300 | $1.2M |
| Vision | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 300 | $1.2M |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 191 | $103K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 191 | $103K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 191 | $103K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 300 | $1.2M |
| Other(2 contracts, 2 carriers) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 300 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 300 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.