| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KEVIN P CALLAHAN3 Filed as: KEVIN P. CALLAHAN | 521 EAST MOREHEAD STREET, SUITE 300 CHARLOTTE, NC 28202 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $21K | $0 | $21K | 2.40% |
| SCOTT C. ANDERSON3 Filed as: SCOTT C. HENDERSON | 432 HIGHLAND FOREST DRIVE CHARLOTTE, NC 28270 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $7K | $0 | $7K | 0.83% |
| JAMES A SCOTT & SON INC3 Filed as: JAMES A. SCOTT AND SON, INC. | 628 GREEN VALLEY ROAD GREENSBORO, NC 27408 | DELTA DENTAL OF NORTH CAROLINA | $4K | $0 | $4K | 7.59% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62689 VIRGINIA BEACH, VA 23466 | DELTA DENTAL OF NORTH CAROLINA | $1K | $0 | $1K | 2.40% |
| JAMES A SCOTT & SON INC3 Filed as: JAMES A. SCOTT AND SON, INC. | 1301 OLD GRAVES MILL ROAD LYNCHBURG, VA 24502 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | $0 | $3K | 7.12% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP SERVICES, LLC | PO BOX 2291 DURHAM, NC 27702 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | $0 | $2K | 5.33% |
| USI INSURANCE SERVICES LLC3 | 6100 FAIRVIEW ROAD, SUITE 1400 CHARLOTTE, NC 28210 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | $0 | $1K | 3.28% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP, INC. | 965 GREENTREE ROAD, SUITE 110 PITTSBURGH, PA 15224 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $556 | $556 | 1.22% |
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 | 144 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 144 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 160 | $879K |
| Dental | DELTA DENTAL OF NORTH CAROLINA | 137 | $49K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 187 | $45K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 187 | $45K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 187 | $45K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 160 | $879K |
| Other | PRINCIPAL LIFE INSURANCE COMPANY | 187 | $45K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 187 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.