| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 6100 FAIRVIEW RD SUITE 1400 CHARLOTTE, NC 28210 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $22K | $4K | $25K | 11.64% |
| USI INSURANCE SERVICES LLC3 | 6100 FAIRVIEW RD CHARLOTTE, NC 28210 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $12K | $2K | $14K | 11.66% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62819 VIRGINIA BEACH, VA 23466 | VISION SERIVCE PLAN | $2K | — | $2K | 3.24% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL | PO BOX 203508 DALLAS, TX 75320 | VISION SERIVCE PLAN | $2 | — | $2 | 0.00% |
| USI INSURANCE SERVICES LLC3 | 6100 FAIRVIEW RD SUITE 1400 CHARLOTTE, NC 28210 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | $652 | $5K | 11.65% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTHGRAM EIN 56-1449504 | Claims processing Service code 12 | PO BOX 11088 CHARLOTTE, NC 28220 | $292K |
| USI INSURANCE SERVICES LLC EIN 13-3771734 | Consulting (general); Insurance agents and brokers Service code 16 | PO BOX 62819 VIRGINIA BEACH, VA 23466 | $38K |
| B V HEDRICK GRAVEL & SAND COMPANY EIN 56-0257665 PLAN SPONSOR | Accounting (including auditing); Plan Administrator Service code 10 | PO BOX 1040 SALISBURY, NC 28145 | $23K |
| ANDERSON SMITH & WIKE EIN 27-1473864 | Accounting (including auditing) Service code 10 | 117 STONE HARBOR CT STATESVILLE, NC 28677 | $6K |
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 | 652 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 654 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERIVCE PLAN | 580 | $68K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 846 | $40K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 674 | $218K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 662 | $121K |
| Stop-loss / reinsurancereinsurance | ANTHEM LIFE INSURANCE COMPANY | 589 | $570K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 846 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.