| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOHN K. GREENE3 | 8540 COLONNADE CENTER DRIVE RALEIGH, NC 28403 | BLUECROSS BLUESHIELD OF NORTH CAROLINA | $47K | $0 | $47K | 3.26% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 203510 DALLAS, TX 75320 | STANDARD INSURANCE COMPANY | $8K | $0 | $8K | 9.25% |
| IBSI HOLDINGS INC3 Filed as: IBSI HOLDING, INC. | 1381 OLD MILL CIRCLE, SUITE 301 WINSTON SALEM, NC 27103 | STANDARD INSURANCE COMPANY | $4K | $0 | $4K | 4.77% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 203066 DALLAS, TX 75320 | STANDARD INSURANCE COMPANY | $201 | $0 | $201 | 0.24% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 6100 FAIRVIEW ROAD, SUITE 1000 CHARLOTTE, NC 28210 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $5K | $0 | $5K | 10.00% |
| IBSI HOLDINGS INC3 Filed as: IBSI HOLDINGS, INC. | PO BOX 24337 WINSTON SALEM, NC 27114 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 5.65% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 601478 CHARLOTTE, NC 28260 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $157 | $0 | $157 | 0.33% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $61 | $61 | 0.13% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 203508 DALLAS, TX 75320 | COMMUNITY EYE CARE | $2K | $0 | $2K | 10.00% |
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 | 164 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 166 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF NORTH CAROLINA | 393 | $1.5M |
| Dental | STANDARD INSURANCE COMPANY | 174 | $83K |
| Vision | COMMUNITY EYE CARE | 394 | $18K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 209 | $48K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 209 | $48K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 209 | $48K |
| Prescription drug | BLUECROSS BLUESHIELD OF NORTH CAROLINA | 393 | $1.5M |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 209 | $48K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 394 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.