| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 4819 EMPEROR BLVD STE 200 DURHAM, NC 27703 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $153K | $0 | $153K | 2.14% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES, I | 980 WASHINGTON STREET, SUITE 325 DEDHAM, MA 02026 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $60K | $0 | $60K | 0.83% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP SERVICES, LLC | 4611 UNIVERSITY DR DURHAM, NC 27702 | HARTFORD LIFE AND ACCIDENT | $0 | $55K | $55K | 9.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | PO BOX 95287 CHICAGO, IL 60694 | HARTFORD LIFE AND ACCIDENT | $18K | -$37 | $18K | 3.29% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES IN | 901 MARQUETTE AVE, SUITE 1800 MINNEAPOLIS, MN 55402 | HARTFORD LIFE AND ACCIDENT | $7K | $0 | $7K | 1.35% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES, I | 100 RIALTO PLACE, SUITE 900 MELBOURNE, FL 32901 | HARTFORD LIFE AND ACCIDENT | $0 | $1K | $1K | 0.25% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 4819 EMPEROR BLVD STE 200 DURHAM, NC 27703 | EYEMED VISION CARE OBO FIDELITY SECURITY LIFE INSURANCE COMPANY | $6K | $0 | $6K | 6.58% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 4819 EMPEROR BLVD SUITE 200 DURHAM, NC 27703 | EYEMED VISION CARE OBO THE FIDELITY SECURITY LIFE INSURANCE COMPANY | $51 | $0 | $51 | 5.91% |
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 | 785 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 794 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 718 | $7.1M |
| Dental | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 718 | $7.1M |
| Vision(2 contracts, 2 carriers) | EYEMED VISION CARE OBO FIDELITY SECURITY LIFE INSURANCE COMPANY | 1,161 | $90K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 785 | $546K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 785 | $546K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 785 | $546K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 718 | $7.1M |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 785 | $565K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,161 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.