| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOHN MCDONNELL3 | 2301 SUGAR BUSH ROAD, SUITE 22 RALEIGH, NC 27612 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $20K | $0 | $20K | 2.94% |
| JOHN MCDONNELL3 | 2301 SUGAR BUSH ROAD, SUITE 22 RALEIGH, NC 27612 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $10K | $0 | $10K | 3.09% |
| MARSH & MCLENNAN AGENCY LLC3 | 3625 N ELM ST STE 200 GREENSBORO, NC 27455 | PRINCIPAL LIFE INSURANCE COMPANY | $12K | $1K | $13K | 11.77% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP SERVICES LLC | PO BOX 2291 DURHAM, NC 27702 | PRINCIPAL LIFE INSURANCE COMPANY | $6K | $0 | $6K | 4.99% |
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 | 249 | 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) | 249 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 295 | $1.0M |
| Dental(2 contracts) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 295 | $1.0M |
| Vision(2 contracts) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 295 | $1.0M |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 295 | $114K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 295 | $114K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 295 | $114K |
| Prescription drug(2 contracts) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 295 | $1.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 295 | — |
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."
No prospect flags tripped on this filing.