| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOHN W DEYTON3 | PO BOX 19943 RALEIGH, NC 27619 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $19K | $2K | $20K | 3.50% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL CAROLINA | 333 N GREENE ST STE 101 GREENSBORO, NC 27401 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 5.36% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL CAROLINA | 1001 MOREHEAD SQUARE DRIVE STE 400 CHARLOTTE, NC 28278 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $189 | — | $189 | 0.41% |
| BANYAN CONSULTING GROUP INC3 | 333 N GREENE STREET STE 101 GREENSBORO, NC 27401 | USABLE LIFE | $4K | — | $4K | 11.07% |
| MOSAIC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $2K | — | $2K | 5.59% |
| BANYAN CONSULTING GROUP INC3 | 333 N GREENE ST STE 101 GREENSBORO, NC 27401 | VISION SERVICE PLAN | $568 | — | $568 | 8.93% |
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 | 104 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 105 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 136 | $585K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 79 | $46K |
| Vision | VISION SERVICE PLAN | 56 | $6K |
| Life insurance | USABLE LIFE | 105 | $35K |
| Short-term disability | USABLE LIFE | 105 | $35K |
| Long-term disability | USABLE LIFE | 105 | $35K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 136 | $585K |
| Other | USABLE LIFE | 105 | $35K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 136 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.