| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PILOT FINANCIAL BRKG INC3 | 3608 W FRIENDLY AVE, STE 212 GREENSBORO, NC 27410 | STANDARD INSURANCE COMPANY | $5K | $811 | $6K | 4.62% |
| PILOT FINANCIAL BRKG INC3 Filed as: PILOT FINANCIAL BRKG INC. | 3608 W. FRIENDLY AVE, STE 212 GREENSBORO, NC 27410 | STANDARD INSURANCE COMPANY | $4K | $288 | $4K | 4.26% |
| PILOT FINANCIAL BRKG INC3 | 3608 W FRIENDLY AVE, STE 212 GREENSBORO, NC 27410 | STANDARD INSURANCE COMPANY | $3K | $440 | $4K | 4.38% |
| PILOT FINANCIAL BRKG INC3 | 3608 W FRIENDLY AVE, STE 212 GREENSBORO, NC 27410 | STANDARD INSURANCE COMPANY | $3K | $445 | $4K | 4.51% |
| PILOT FINANCIAL BRKG INC3 | 3608 W FRIENDLY AVE SUITE 212 GREENSBORO, NC 27410 | STANDARD INSURANCE COMPANY | $302 | $36 | $338 | 4.47% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PIAS RISK MGT AND SERV. CO. INC. EIN 62-1346425 SERVICE PROVIDER | Recordkeeping and information management (computing, tabulating, data processing, etc.); Plan Administrator; Direct payment from the plan; Other services Service code 14 | — | $119K |
| LBMC EIN 62-1199757 AUDITOR | Accounting (including auditing) Service code 10 | — | $19K |
| THE TRAVELERS INDEMNITY COMPANY EIN 06-0566050 SERVICE PROVIDER | Direct payment from the plan; Insurance services Service code 23 | — | $10K |
| CHAMP IT SOLUTIONS, INC EIN 27-3152583 SERVICE PROVIDER | Other services Service code 49 | — | $9K |
| PIAS INC. EIN 62-0304765 SERVICE PROVIDER | Employee (plan sponsor); Direct payment from the plan Service code 35 | — | $8K |
| ADAMS AND REESE LLP EIN 72-0424362 ATTORNEYS | Legal Service code 29 | — | $7K |
| PRINTING INDUSTRIES OF NEW ENGLAND EIN 04-2105911 AFFILIATE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $6K |
| PRINT & GRAPHIC COMM. ASSOC EIN 31-4284340 SERVICE PROVIDER | Direct payment from the plan; Other services Service code 49 | — | $5K |
| PRINTING INDUSTRIES OF GEORGIA EIN 58-0146550 AFFILIATE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $5K |
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 | 1,142 | 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) | 1,142 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | STANDARD INSURANCE COMPANY | 119 | $96K |
| Vision | STANDARD INSURANCE COMPANY | 53 | $8K |
| Life insurance | STANDARD INSURANCE COMPANY | 744 | $88K |
| Short-term disability | STANDARD INSURANCE COMPANY | 270 | $85K |
| Long-term disability | STANDARD INSURANCE COMPANY | 495 | $130K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 744 | — |
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."
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.