| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STEALTH PARTNER GROUP LLC3 Filed as: STEALTH BENEFIT SOLUTIONS | 18940 NORTH PIMA ROAD #210 SCOTTSDALE, AZ 85255 | UNIMERICA INSURANCE COMPANY | $5K | $0 | $5K | 2.99% |
| GROUP BENEFIT SOLUTIONS3 | 580 DAVIDSON GATEWAY DRIVE DAVIDSON, NC 28036 | STANDARD INSURANCE COMPANY | $6K | $0 | $6K | 5.99% |
| IBSI HOLDINGS INC3 | 1381 OLD MILL CIRCLE WINSTON-SALEM, NC 27103 | STANDARD INSURANCE COMPANY | $3K | $0 | $3K | 3.11% |
| GROUP BENEFIT SOLUTIONS3 | 580 DAVIDSON GATEWAY DRIVE DAVIDSON, NC 28036 | DEARBORN NATIONAL | $9K | $4K | $14K | 22.29% |
| IBSI HOLDINGS INC3 | PO BOX 24337 WINSTON-SALEM, NC 27114 | DEARBORN NATIONAL | $0 | $3K | $3K | 5.00% |
| GROUP BENEFIT SOLUTIONS3 | 580 DAVIDSON GATEWAY DRIVE DAVIDSON, NC 28036 | EYEMED | $2K | $0 | $2K | 24.97% |
| IBSI HOLDINGS INC3 | P O BOX 24337 WINSTON-SALEM, NC 27114 | EYEMED | $0 | $419 | $419 | 4.63% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CORESOURCE INC. EIN 35-1846036 NONE | Other services; Plan Administrator; Claims processing Service code 12 | 2105 WATER RIDGE PARKWAY CHARLOTTE, NC 28217 | $42K |
| GROUP BENEFIT SOLUTIONS EIN 27-1018705 NONE | Consulting (general); Insurance agents and brokers Service code 16 | 580 GATEWAY DRIVE DAVIDSON, NC 28036 | $34K |
| CIGNA PPO EIN 59-1031071 NONE | Claims processing; Other services Service code 12 | 900 COTTAGE GROVE RD BLOOM FIELD, CT 06002 | $17K |
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 | 111 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 111 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | STANDARD INSURANCE COMPANY | 95 | $105K |
| Vision | EYEMED | 115 | $9K |
| Life insurance | DEARBORN NATIONAL | 121 | $61K |
| Short-term disability | DEARBORN NATIONAL | 121 | $61K |
| Long-term disability | DEARBORN NATIONAL | 121 | $61K |
| Stop-loss / reinsurancereinsurance | UNIMERICA INSURANCE COMPANY | 93 | $161K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 121 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.