| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SCOTT INSURANCE3 | 2501 BLUE RIDGE ROAD, STE 250 RALEIGH, NC 27607 | HCC LIFE INSURANCE COMPANY | $79K | $0 | $79K | 3.60% |
| COMMUNITY BANK SERVICES3 Filed as: COMMUNITY BANK SERVICES, INC. | 3601 HAWORTH DRIVE RALEIGH, NC 276097218 | HCC LIFE INSURANCE COMPANY | $53K | $0 | $53K | 2.40% |
| SCOTT INSURANCE3 | 1301 OLD GRAVES MILL ROAD LYNCHBURG, VA 24502 | HCC LIFE INSURANCE COMPANY | $0 | $10K | $10K | 0.47% |
| C2 CENTRIC LLC3 | PO BOX 6824 GRAND RAPIDS, MI 49516 | HCC LIFE INSURANCE COMPANY | $0 | $5K | $5K | 0.23% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMUNITY BANK SERVICES INC EIN 56-1268430 THIRD PARTY ADMINISTRATOR | Contract Administrator Service code 13 | 3601 HAWORTH DRIVE RALEIGH, NC 27609 | $1.2M |
| SENTRY HEALTH EIN 88-0834914 MONITORING SERVICES | Consulting (general) Service code 16 | 7410 NEW LA GRANCE RD STE 205 LOUISVILLE, KY 40222 | $141K |
| HCMS GROUP EIN 27-1478411 HEALTH INFORMATION SERVIC | Participant communication Service code 38 | 600 GRANT ST PITTSBURGH, PA 15219 | $74K |
| JOHNSON LAMBERT LLP EIN 52-1446779 AUDIT AND TAX SERVICES | Accounting (including auditing) Service code 10 | 4242 SIX FORKS RD, STE 1500 RALEIGH, NC 27609 | $62K |
| SCOTT INSURANCE EIN 54-0372970 ADVISORY SERVICES | Other insurance fees and expenses; Non-monetary compensation Service code 56 | 2501 BLUE RIDGE RD STE 250 RALEIGH, NC 27607 | $54K |
| BROOKS PIERCE EIN 56-0561489 LEGAL SERVICES | Legal Service code 29 | 150 FAYETTEVILLE ST 1700 RALEIGH, NC 27601 | $44K |
| RUDD & WISDOM, INC. EIN 74-1896655 ACTUARY | Actuarial Service code 11 | 9500 ARBORETUM BLVD., STE 200 AUSTIN, TX 78759 | $28K |
| ZURICH INSURANCE CO. INSURANCE AGENT | Insurance agents and brokers Service code 22 | 1299 ZURICH WAY SCHAUMBURG, IL 601961056 | $13K |
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 | 2,139 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 34 | Continuation coverage (COBRA, retiree health). |
| Beneficiaries receiving benefits | 3 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 2,176 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 3,794 | $0 |
| Dental | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 3,794 | $0 |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 2,169 | $2.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,794 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.