| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JEFF J. RIES3 | 1013 WOODKIRK LANE MATTHEWS, NC 28104 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $94K | $725 | $94K | 3.22% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4064 COLONY ROAD, SUITE 200 CHARLOTTE, NC 28211 | AMERITAS LIFE INSURANCE CORPORATION | $5K | $0 | $5K | 3.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 21ST FLOOR ROLLING MEADOWS, IL 60008 | AMERITAS LIFE INSURANCE CORPORATION | $0 | $2K | $2K | 1.13% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4064 COLONY ROAD, SUITE 200 CHARLOTTE, NC 28211 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $13K | $0 | $13K | 7.97% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, INC. | PO BOX 62689 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $0 | $4K | 2.54% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO MORROCROFT CENTRE 4064 COLONY ROAD, SUITE 450 CHARLOTTE, NC 28211 | HARTFORD LIFE AND ACCIDENT | $312 | $0 | $312 | 14.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | HARTFORD LIFE AND ACCIDENT | $0 | $31 | $31 | 1.49% |
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 | 174 | 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) | 174 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 399 | $2.9M |
| Dental | AMERITAS LIFE INSURANCE CORPORATION | 382 | $173K |
| Vision | VISION SERVICE PLAN | 76 | $13K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 174 | $167K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 174 | $167K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 174 | $167K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 399 | $2.9M |
| Other(3 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 174 | $169K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 399 | — |
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.