| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KENNETH CRIST3 | 8540 COLONNADE CENTER DR RALEIGH, NC 27615 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $21K | — | $21K | 2.14% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62819 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $13K | $3K | $16K | 15.28% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS LLC | 669 RIVER DR CTR II STE 305 ELMWOOD PARK, NJ 07407 | HARTFORD LIFE AND ACCIDENT | — | $5K | $5K | 4.98% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP SERVICES LLC | PO BOX 2291 DURHAM, NC 27702 | HARTFORD LIFE AND ACCIDENT | — | $24 | $24 | 0.02% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62689 VIRGINIA BEACH, VA 23466 | DELTA DENTAL OF NORTH CAROLINA | $2K | — | $2K | 2.97% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62819 VIRGINIA BEACH, VA 23466 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | $9 | $1K | 10.07% |
| ROGERS BENEFIT GROUP INC3 Filed as: EMMERSON ROGERS, LLC | 1787 SENTRY PKWY W BLUE BELL, PA 19422 | PRINCIPAL LIFE INSURANCE COMPANY | — | $97 | $97 | 0.91% |
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 | 80 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 85 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 179 | $983K |
| Dental | DELTA DENTAL OF NORTH CAROLINA | 184 | $72K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 163 | $11K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 84 | $102K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 84 | $102K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 84 | $102K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 179 | $983K |
| Other | HARTFORD LIFE AND ACCIDENT | 84 | $102K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 184 | — |
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."
No prospect flags tripped on this filing.