| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SCOTT C. ANDERSON3 | 432 HIGHLAND FOREST DRIVE CHARLOTTE, NC 28270 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $31K | $0 | $31K | 3.25% |
| USI INSURANCE SERVICES LLC3 | 6100 FAIRVIEW ROAD, SUITE 1400 CHARLOTTE, NC 28210 | PRINCIPAL LIFE INSURANCE COMPANY | $5K | $423 | $6K | 10.74% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP SERVICES, LLC | PO BOX 2291 DURHAM, NC 27702 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $3K | $3K | 4.95% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62689 VIRGINIA BEACH, VA 23466 | DELTA DENTAL OF NORTH CAROLINA | $5K | $0 | $5K | 9.82% |
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 | 153 | 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) | 153 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 146 | $965K |
| Dental | DELTA DENTAL OF NORTH CAROLINA | 147 | $54K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 212 | $55K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 212 | $55K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 212 | $55K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 146 | $965K |
| Other | PRINCIPAL LIFE INSURANCE COMPANY | 212 | $55K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 212 | — |
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.