| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP SERVICES LLC | 4615 UNIVERSITY DRIVE DURHAM, NC 27707 | SYMETRA LIFE INSURANCE COMPANY | $4K | — | $4K | 5.00% |
| WATCHTOWER TECHNOLOGIES INC3 | 2734 N MILDRED AVE #3 CHICAGO, IL 60614 | SYMETRA LIFE INSURANCE COMPANY | — | $2K | $2K | 2.53% |
| JAMES A SCOTT & SON INC3 | 1301 OLD GRAVES MILL RD LYNCHBURG, VA 24502 | SYMETRA LIFE INSURANCE COMPANY | — | $2K | $2K | 2.30% |
| IBENEFIT COMMUNICATION LLC3 Filed as: IBENEFIT COMMUNICATIONS LLC | 6230 FAIRVIEW RD #210 CHARLOTTE, NC 28210 | SYMETRA LIFE INSURANCE COMPANY | $6K | — | $6K | 16.92% |
| JAMES A SCOTT & SON INC3 | 1301 OLD GRAVES MILL RD LYNCHBURG, VA 24502 | SYMETRA LIFE INSURANCE COMPANY | $3K | $416 | $3K | 8.37% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP SERVICES LLC | 4615 UNIVERSITY DRIVE DURHAM, NC 27707 | SYMETRA LIFE INSURANCE COMPANY | — | $1K | $1K | 3.90% |
| RUTH A ANDERSON4 | 331 S FAYETTEVILLE STREET CLAYTON, NC 27520 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $1K | — | $1K | 14.72% |
| JAMES A SCOTT & SON INC4 Filed as: JAMES A SCOTT AND SON INC | 1301 OLD GRAVES MILL RD LYNCHBURG, VA 24502 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $619 | — | $619 | 8.34% |
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 | 113 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 114 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 188 | $1.3M |
| Dental | DELTA DENTAL OF NORTH CAROLINA | 248 | $94K |
| Vision | EYEMED VISION CARE OBO THE FIDELITY SECURITY LIFE INSURANCE COMPANY | 242 | $16K |
| Life insurance | SYMETRA LIFE INSURANCE COMPANY | 113 | $84K |
| Short-term disability | SYMETRA LIFE INSURANCE COMPANY | 113 | $84K |
| Long-term disability | SYMETRA LIFE INSURANCE COMPANY | 113 | $84K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 188 | $1.3M |
| Other(3 contracts, 2 carriers) | SYMETRA LIFE INSURANCE COMPANY | 171 | $129K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 248 | — |
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."
No prospect flags tripped on this filing.