| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EMILY P. KNOWLES3 Filed as: EMILY P. KNOWELS | 8049 CORPORATE CENTER DRIVE CHARLOTTE, NC 28226 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $1K | $0 | $1K | 0.06% |
| UNKNOWN3 | UNKNOWN CHARLOTTE, NC 28208 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $709 | $0 | $709 | 0.03% |
| ERIC W. BLACK3 | 4064 COLONY ROAD, SUITE 450 CHARLOTTE, NC 28211 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $350 | $0 | $350 | 0.01% |
| MOSAIC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $3K | $0 | $3K | 5.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62689 VIRGINIA BEACH, VA 23466 | USABLE LIFE | $0 | $824 | $824 | 1.54% |
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 | 156 | 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) | 156 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 366 | $2.7M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF NORTH CAROLINA | 390 | $392K |
| Life insurance | DELAWARE AMERICAN LIFE INSURANCE COMPANY | 11 | $118K |
| Long-term disability | USABLE LIFE | 148 | $54K |
| Prescription drug(3 contracts, 3 carriers) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 366 | $2.7M |
| Other | DELAWARE AMERICAN LIFE INSURANCE COMPANY | 11 | $118K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 390 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
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.