| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT MARK MCLEAN | P O BOX 1889 FORT MILL, SC 29716 | BLUECROSS BLUESHIELD OF NORTH CAROLINA | $14K | $0 | $14K | 1.57% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY STE 1950 ATLANTA, GA 30339 | GUARDIAN | $14K | $7K | $20K | 13.04% |
| CENTRO BENEFITS RESEARCH LLC3 | 325 N. KIRKWOOD RD SUITE 300 KIRKWOOD, MO 63122 | GUARDIAN | $8K | $0 | $8K | 5.00% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY | 899 CASSAT RD STE 200 BERWYN, PA 19312 | ARMADA CARE | $6K | $0 | $6K | 6.57% |
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 | 137 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 140 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF NORTH CAROLINA | 99 | $916K |
| Dental | GUARDIAN | 140 | $155K |
| Vision | GUARDIAN | 140 | $155K |
| Short-term disability | GUARDIAN | 140 | $155K |
| Long-term disability | GUARDIAN | 140 | $155K |
| Prescription drug | BLUECROSS BLUESHIELD OF NORTH CAROLINA | 99 | $916K |
| Other(3 contracts, 3 carriers) | BLUECROSS BLUESHIELD OF NORTH CAROLINA | 140 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 140 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.