| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MOSAIC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $3K | $0 | $3K | 5.31% |
| MOSAIC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $2K | $0 | $2K | 5.38% |
| MOSAIC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $2K | $0 | $2K | 10.75% |
| MOSAIC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $205 | $0 | $205 | 10.81% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTHGRAM, INC. EIN 56-1449504 MEDICAL TPA | Insurance agents and brokers Service code 22 | — | $65K |
| MAIN STREET SWIMMER EIN 56-2185489 BROKER | Insurance agents and brokers Service code 22 | — | $54K |
| CIGNA CORPORATION EIN 59-1031071 N/A | Claims processing Service code 12 | — | $26K |
| ADVOSEE EIN 85-4312283 N/A | Claims processing Service code 12 | — | $19K |
| FLORES AND ASSOCIATES EIN 56-1542307 FSA ADMIN | Claims processing Service code 12 | — | $5K |
| CAREOPERATIVE LLC EIN 20-8981027 N/A | Claims processing Service code 12 | — | $2K |
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 |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 104 | $13K |
| Life insurance | USABLE LIFE | 153 | $58K |
| Long-term disability | USABLE LIFE | 153 | $42K |
| Stop-loss / reinsurancereinsurance | SWISS RE CORPORATE SOLUTIONS AMERICA INS. CORP. | 134 | $441K |
| Other(5 contracts, 2 carriers) | USABLE LIFE | 153 | $131K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 153 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.