| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EBENCONCEPTS COMPANY3 Filed as: EBENCONCEPTS COMPANY, INC. | 921-C S. MCPHERSON CHURCH ROAD FAYETTEVILLE, NC 28303 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $9K | — | $9K | 5.16% |
| EBENCONCEPTS COMPANY3 Filed as: EBENCONCEPTS COMPANY, INC. | 921-C S. MCPHERSON CHURCH ROAD FAYETTEVILLE, NC 28303 | USABLE LIFE | $847 | — | $847 | 9.99% |
| MOSAIC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $423 | — | $423 | 4.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPLOYERS DIRECT HEALTH EIN 75-2322062 CLAIMS ADMINISTRATOR | Contract Administrator; Claims processing; Other fees Service code 12 | — | $84K |
| EBENCONCEPTS COMPANY, INC. EIN 75-2966596 CONSULTANT | Consulting fees; Consulting (general) Service code 16 | — | $24K |
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 | 248 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 248 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 248 | $176K |
| Life insurance | USABLE LIFE | 174 | $8K |
| Stop-loss / reinsurancereinsurance | FIDELITY SECURITY LIFE INSURANCE COMPANY | 200 | $237K |
| Other | USABLE LIFE | 174 | $8K |
| 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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.