| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF SOUTH CAROLINA LLC | 5955 CARNEGIE BLVD., STE. 150 CHARLOTTE, NC 28209 | AMERITAS LIFE INSURANCE CORP | $20K | — | $20K | 7.97% |
| EMPLOYEE BENEFIT ADVISORS OF THE CA3 Filed as: EMPLOYEE BENEFIT ADVISORS CAROLINAS | 5955 CARNEGIE BLVD., STE. 150 CHARLOTTE, NC 28209 | AMERITAS LIFE INSURANCE CORP | $5K | $282 | $5K | 2.14% |
| EMPLOYEE BENEFIT ADVISORS OF THE CA3 Filed as: EMPLOYEE BENEFIT ADVISORS CAROLINAS | 5955 CARNEGIE BLVD., STE. 150 CHARLOTTE, NC 28209 | USABLE LIFE INSURANCE COMPANY | $8K | — | $8K | 8.64% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF SOUTH CAROLINA | 7621 LITTLE AVE SUITE 113 CHARLOTTE, NC 28226 | USABLE LIFE INSURANCE COMPANY | $6K | — | $6K | 6.36% |
| MOSAIC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE INSURANCE COMPANY | $5K | — | $5K | 5.00% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF SOUTH CAROLINA | 5955 CARNEGIE BLVD., STE. 150 CHARLOTTE, NC 28209 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 15.81% |
| MOSAIC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $5K | — | $5K | 10.01% |
| EMPLOYEE BENEFIT SERVICES3 Filed as: EMPLOYEE BENEFIT ADVISORS | 5955 CARNEGIE BLVD., STE. 150 CHARLOTTE, NC 28209 | USABLE LIFE | $4K | $52 | $5K | 8.65% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF SOUTH CAROLINA | 7621 LITTLE AVE., STE. 113 CHARLOTTE, NC 28226 | USABLE LIFE | $3K | — | $3K | 6.46% |
| EMPLOYEE BENEFIT ADVISORS OF THE CA3 Filed as: EMPLOYEE BENEFIT ADVISORS CAROLINAS | 5955 CARNEGIE BLVD., STE. 150 CHARLOTTE, NC 28209 | USABLE LIFE INSURANCE COMPANY | $4K | — | $4K | 8.63% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF SOUTH CAROLINA | 7621 LITTLE AVE SUITE 113 CHARLOTTE, NC 28226 | USABLE LIFE INSURANCE COMPANY | $3K | — | $3K | 6.37% |
| MOSIAC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE INSURANCE COMPANY | $2K | — | $2K | 5.00% |
| RUTH A ANDERSON4 Filed as: RUTH A. ANDERSON | 331 S. FAYETTEVILLE ST. CLAYTON, NC 27520 | PRE-PAID LEVAL SERVICES, INC. DBA LEGALSHIELD | $3K | — | $3K | 25.04% |
| SDM&R, INC DBA SENN DUNN INSURANCE4 Filed as: SDM&R, INC. DBA SENN DUNN INSURANCE | P.O. BOX 9375 GREENSBORO, NC 27429 | PRE-PAID LEVAL SERVICES, INC. DBA LEGALSHIELD | $95 | — | $95 | 0.95% |
| MOSAIC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $574 | — | $574 | 10.00% |
| EMPLOYEE BENEFIT SERVICES3 Filed as: EMPLOYEE BENEFIT ADVISORS | 5955 CARNEGIE BLVD SUITE 150 CHARLOTTE, NC 28209 | USABLE LIFE | $512 | $7 | $519 | 9.04% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF SOUTH CAROLINA | 7621 LITTLE AVE SUITE 113 CHARLOTTE, NC 28226 | USABLE LIFE | $350 | — | $350 | 6.10% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF NC EIN 56-0894904 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $119K |
| FLORES & ASSOCIATES EIN 56-1542307 TPA | Contract Administrator Service code 13 | — | $10K |
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 | 310 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 317 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AMERITAS LIFE INSURANCE CORP | 567 | $255K |
| Vision | AMERITAS LIFE INSURANCE CORP | 567 | $255K |
| Life insurance(2 contracts, 2 carriers) | USABLE LIFE | 310 | $98K |
| Long-term disability | USABLE LIFE INSURANCE COMPANY | 287 | $95K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 592 | $1.1M |
| Other(4 contracts, 4 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 342 | $115K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 592 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.