| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DONALD HARDIN3 | 100 N. TRYON STREET SUITE 3400 CHARLOTTE, NC 28202 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $57K | $3K | $60K | 1.50% |
| JOANNE FORBES3 | 4819 EMPEROR BLVD SUITE 200 DURHUM, NC 27703 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $20K | — | $20K | 0.51% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $30K | — | $30K | 3.89% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 4819 EMPEROR BLVD SUITE 200 DURHAM, NC 27703 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $11K | — | $11K | 1.39% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 400 MIDLAND DRIVE SUITE 300 MT LAUREL, NJ 08054 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 1.06% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $144 | $144 | 0.02% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVE STE 1100 CHICAGO, IL 606036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $25 | $25 | 0.00% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | METROPOLITAN LIFE INSURANCE COMPANY | $37K | $24 | $37K | 5.10% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 4819 EMPEROR BLVD SUITE 200 DURHAM, NC 27703 | METROPOLITAN LIFE INSURANCE COMPANY | $21K | $41 | $21K | 2.91% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | METROPOLITAN LIFE INSURANCE COMPANY | — | $6K | $6K | 0.80% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | METROPOLITAN LIFE INSURANCE COMPANY | — | $5K | $5K | 0.70% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1111 SUPERIOR AVE E STE 1601 CLEVELAND, OH 44114 | METROPOLITAN LIFE INSURANCE COMPANY | — | $27 | $27 | 0.00% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | METROPOLITAN LIFE INSURANCE COMPANY | — | $9 | $9 | 0.00% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $6K | — | $6K | 5.29% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 4819 EMPEROR BLVD STE 200 DURHAM, NC 27703 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $4K | — | $4K | 4.01% |
| HCW EMPLOYEE BENEFIT SERVICES, LLC3 | 4819 EMPEROR BLVD STE 200 DURHAM, NC 27703 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $10 | — | $10 | 0.01% |
| GETTYSBURG BENEFITS ADMINISTRATORS3 | P.O. BOX 1060 GETTYSBURG, PA 17325 | HARTFORD LIFE AND ACCIDENT | $9K | — | $9K | 8.79% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP SERVICES, LLC | 4611 UNIVERSITY DRIVE DURHAM, NC 27702 | HARTFORD LIFE AND ACCIDENT | — | $8K | $8K | 7.64% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 4819 EMPEROR BLVD STE 200 DURHAM, NC 27703 | HARTFORD LIFE AND ACCIDENT | $7K | — | $7K | 6.50% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HARTFORD LIFE AND ACCIDENT | $6K | — | $6K | 5.87% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $64 | — | $64 | 6.38% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 4819 EMPEROR BLVD STE 200 DURHAM, NC 27703 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $9 | — | $9 | 0.90% |
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 | 769 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 14 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 783 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 1,417 | $4.0M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 1,874 | $732K |
| Vision(2 contracts) | FIDELITY SECURITY LIFE INSURANCE COMPANY | 1,368 | $110K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 791 | $771K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 791 | $771K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 791 | $771K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 1,417 | $4.0M |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 791 | $885K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,874 | — |
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.