| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD FL 11 ROLLING MEADOWS, IL 60008 | PRINCIPAL LIFE INSURANCE COMPANY | $724 | — | $724 | 5.47% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP SERVICES LLC | PO BOX 2291 DURHAM, NC 27702 | PRINCIPAL LIFE INSURANCE COMPANY | $591 | $52 | $643 | 4.86% |
| RDM BENEFITS AND FINANCIAL SVCS INC3 | 208 BROOKSTONE DRIVE ADVANCE, NC 27006 | PRINCIPAL LIFE INSURANCE COMPANY | $639 | — | $639 | 4.83% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4819 EMPEROR BLVD STE 200 DURHAM, NC 27703 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $456 | — | $456 | 5.66% |
| RDM BENEFITS INC3 | PO BOX 520 HOLLY SPRINGS, NC 27540 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | — | $12 | 3.26% |
| ROBERT W. FOXWORTH INC3 Filed as: ROBERT W FOXWORTH INC | 217 BRANCHSIDE LANE HOLLY SPRINGS, NC 27540 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | — | $10 | 2.72% |
| BENEFITS COUNT INC3 Filed as: BENEFITS COUNT II INC | 1401 CHRISTMAS COURT RALEIGH, NC 27604 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.82% |
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 | 194 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 195 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 283 | $8K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 297 | $13K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 297 | $13K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 297 | $13K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 297 | $13K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 297 | $13K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 283 | $8K |
| Other | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 7 | $368 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 297 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.