| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RALPH COOMER3 | PO BOX 1381 CARRBORO, NC 27510 | USABLE | $11K | — | $11K | 18.33% |
| MOSAIC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | USABLE | $6K | — | $6K | 10.00% |
| EB ADVISORS OF THE CAROLINAS, LLC3 Filed as: EB ADVISORS OF THE CAROLINAS LLC | 5955 CARNEGIE BOULEVARD SUITE 150 CHARLOTTE, NC 28209 | USABLE | $396 | — | $396 | 0.67% |
| RALPH COOMER3 | PO BOX 1381 CARRBORO, NC 27510 | USABLE | $8K | — | $8K | 17.02% |
| MOSAIC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | USABLE | $5K | — | $5K | 9.98% |
| EB ADVISORS OF THE CAROLINAS, LLC3 Filed as: EB ADVISORS OF THE CAROLINAS LLC | 5955 CARNEGIE BOULEVARD SUITE 150 CHARLOTTE, NC 28209 | USABLE | $897 | — | $897 | 1.97% |
| RALPH COOMER3 | PO BOX 1381 CARRBORO, NC 27510 | USABLE | $4K | — | $4K | 13.82% |
| MOSAIC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | USABLE | $2K | — | $2K | 5.00% |
| EB ADVISORS OF THE CAROLINAS, LLC3 Filed as: EB ADVISORS OF THE CAROLINAS LLC | 5955 CARNEGIE BOULEVARD SUITE 150 CHARLOTTE, NC 28209 | USABLE | $375 | — | $375 | 1.18% |
| RALPH COOMER3 | PO BOX 1381 CARBORO, NC 27510 | USABLE LIFE | $1K | — | $1K | 13.83% |
| MOSAIC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $440 | — | $440 | 5.00% |
| EB ADVISORS OF THE CAROLINAS, LLC3 Filed as: EB ADVISORS OF THE CAROLINAS LLC | 5955 CARNEGIE BOULEVARD SUITE 150 CHARLOTTE, NC 28209 | USABLE LIFE | $102 | — | $102 | 1.16% |
| RALPH COOMER3 | PO BOX 1381 CARRBORO, NC 27510 | USABLE | $839 | — | $839 | 17.49% |
| MOSAIC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | USABLE | $479 | — | $479 | 9.98% |
| EB ADVISORS OF THE CAROLINAS, LLC3 Filed as: EB ADVISORS OF THE CAROLINAS LLC | 5955 CARNEGIE BOULEVARD SUITE 150 CHARLOTTE, NC 28209 | USABLE | $72 | — | $72 | 1.50% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF NC EIN 56-0894904 NONE | Insurance agents and brokers Service code 22 | PO BOX 2291 DURHAM, NC 27702 | $112K |
| SUZANNE JOHNSON NONE | Insurance agents and brokers Service code 22 | 5955 CARNEGIE BOULEVARD SUITE 150 CHARLOTTE, NC 28209 | $42K |
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 | 203 | 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. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 203 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | USABLE | 263 | $54K |
| Short-term disability | USABLE | 289 | $32K |
| Long-term disability | USABLE | 139 | $59K |
| Other | USABLE | 286 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 289 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.