| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF SOUTH CAROLINA LLC | 7621 LITTLE AVE., STE. 113 CHARLOTTE, NC 28226 | AMERITAS LIFE INSURANCE | $25K | — | $25K | 10.00% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF SOUTH CAROLINA | 7621 LITTLE AVE., STE. 113 CHARLOTTE, NC 28226 | USABLE LIFE INSURANCE COMPANY | $14K | — | $14K | 15.00% |
| MOSAIC GROUP SERVICES3 | 1822-B N VIRGINIA DARE TRAIL KILL DEVIL HILLS, NC 27948 | USABLE LIFE INSURANCE COMPANY | $5K | — | $5K | 5.00% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF SOUTH CAROLINA | 7621 LITTLE AVE., STE. 113 CHARLOTTE, NC 28226 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 14.98% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF SOUTH CAROLINA | 7621 LITTLE AVE., STE. 113 CHARLOTTE, NC 28226 | USABLE LIFE INSURANCE COMPANY | $7K | — | $7K | 15.00% |
| MOSAIC GROUP SERVICES3 | 1822-B N VIRGINIA DARE TRAIL KILL DEVIL HILLS, NC 27948 | USABLE LIFE INSURANCE COMPANY | $2K | — | $2K | 5.00% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF SOUTH CAROLINA | 7621 LITTLE AVE., STE. 113 CHARLOTTE, NC 28226 | USABLE LIFE INSURANCE COMPANY | $6K | $146 | $6K | 15.40% |
| MOSAIC GROUP SERVICES3 | 1822-B N VIRGINIA DARE TRAIL KILL DEVIL HILLS, NC 27948 | USABLE LIFE INSURANCE COMPANY | $4K | — | $4K | 10.00% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF SOUTH CAROLINA | 5955 CARNEGIE BLVD., STE. 150 CHARLOTTE, NC 28209 | SYMETRA LIFE INSURANCE COMPANY | $3K | — | $3K | 13.75% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP SERVICES LLC | 4615 UNIVERSITY DR. DURHAM, NC 27707 | SYMETRA LIFE INSURANCE COMPANY | $865 | — | $865 | 3.96% |
| RUTH A ANDERSON4 Filed as: RUTH A. ANDERSON | 331 S. FAYETTEVILLE ST. CLAYTON, NC 27520 | PRE-PAID LEVAL SERVICES, INC. DBA LEGALSHIELD | $2K | — | $2K | 19.26% |
| ANN M PALMER4 | 311 SUNNYSIDE AVE MURRELLS INLET, SC 29576 | PRE-PAID LEVAL SERVICES, INC. DBA LEGALSHIELD | $121 | — | $121 | 1.07% |
| SDM&R, INC DBA SENN DUNN INSURANCE4 | PO BOX 9375 GREENSBORO, NC 27429 | PRE-PAID LEVAL SERVICES, INC. DBA LEGALSHIELD | $83 | — | $83 | 0.74% |
| EMPLOYEE BENEFIT ADVISORS OF THE CA4 Filed as: EMPLOYEE BENEFIT ADISVORS | 5955 CARNEGIE BLVD SUITE 150 CHARLOTTE, NC 28209 | PRE-PAID LEVAL SERVICES, INC. DBA LEGALSHIELD | $30 | — | $30 | 0.27% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF SOUTH CAROLINA LLC | 7621 LITTLE AVE., STE. 113 CHARLOTTE, NC 28226 | USABLE LIFE INSURANCE COMPANY | $766 | $33 | $799 | 15.64% |
| MOSAIC GROUP SERVICES3 | 1822-B N VIRGINIA DARE TRAIL KILL DEVIL HILLS, NC 27948 | USABLE LIFE INSURANCE COMPANY | $511 | — | $511 | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF NC EIN 56-0894904 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $109K |
| FLORES & ASSOCIATES EIN 56-1542307 FSA & HRA ADMINISTRATOR | Contract Administrator Service code 13 | — | $9K |
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 | 321 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 327 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AMERITAS LIFE INSURANCE | 583 | $247K |
| Vision | AMERITAS LIFE INSURANCE | 583 | $247K |
| Life insurance(2 contracts) | USABLE LIFE INSURANCE COMPANY | 321 | $81K |
| Long-term disability | USABLE LIFE INSURANCE COMPANY | 303 | $91K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 594 | $1.2M |
| Other(5 contracts, 4 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 363 | $138K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 594 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.