| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 6100 FAIRVIEW ROAD SUITE 1400 CHARLOTTE, NC 28210 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $20K | — | $20K | 9.70% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COVENTRY HEALTH CARE OF CAROLINAS, EIN 20-0229117 NONE | Claims processing; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $189K |
| GASTON FAMILY HEALTH SERVICES INC. EIN 58-1958398 NONE | Other services Service code 49 | — | $48K |
| WELLS FARGO INSURANCE SERVICES INC. EIN 58-2650555 NONE | Insurance agents and brokers Service code 22 | — | $37K |
| CORPORATE BENEFIT SERVICES INC. EIN 56-1167792 NONE | Insurance agents and brokers; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $25K |
| TEAM PHARMACY CONSULTING EIN 46-5635028 NONE | Other services Service code 49 | — | $15K |
| CAROMONT OCCUPATIONAL MEDICINE, LLC NONE | Other services Service code 49 | PO BOX 1747 GASTONIA, NC 28053 | $15K |
| GREERWALKER LLP EIN 56-1434747 NONE | Accounting (including auditing) Service code 10 | — | $14K |
| STANLEY, HUNT, DUPREE & RHINE NONE | Actuarial Service code 11 | PO BOX 1033 CHARLESTON, WV 25324 | $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 | 804 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 807 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 662 | $202K |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 662 | $202K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 662 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.