| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JEFF J. RIES3 | 1013 WOODKIRK LANE MATTHEWS, NC 28269 | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | $91K | $500 | $92K | 2.91% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62689 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9K | $0 | $9K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC. | 4064 COLONY ROAD, SUITE 450 CHARLOTTE, NC 28211 | AMERITAS LIFE INSURANCE CORPORATION | $4K | $0 | $4K | 2.24% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 8049 CORPORATE CENTER DRIVE CHARLOTTE, NC 28226 | AMERITAS LIFE INSURANCE CORPORATION | $1K | $0 | $1K | 0.76% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 9811 KATY FREEWAY, SUITE 500 HOUSTON, TX 77024 | AMERITAS LIFE INSURANCE CORPORATION | $0 | $634 | $634 | 0.37% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 8049 CORPORATE CENTER DRIVE CHARLOTTE, NC 28226 | VISION SERVICE PLAN | $235 | $0 | $235 | 1.75% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 470 PARK AVENUE SOUTH, 6TH FLOOR NEW YORK, NY 10016 | HARTFORD LIFE AND ACCIDENT | $0 | $29 | $29 | — |
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 | 195 | 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) | 197 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 434 | $3.1M |
| Dental | AMERITAS LIFE INSURANCE CORPORATION | 398 | $170K |
| Vision | VISION SERVICE PLAN | 80 | $13K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 195 | $170K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 195 | $170K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 195 | $170K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 434 | $3.1M |
| Other(3 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 195 | $170K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 434 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.