| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EBENCONCEPTS COMPANY3 | 3150 NORTH ELM STE 201 GREENSBORO, NC 27408 | PRINCIPAL LIFE INSURANCE COMPANY | $29K | — | $29K | 11.04% |
| SELMAN & COMPANY, LLC3 Filed as: SELMAN & COMPANY LLC | 1 INTEGRITY PKWY CLEVELAND, OH 441431500 | PRINCIPAL LIFE INSURANCE COMPANY | — | -$56 | -$56 | -0.02% |
| NORTH STATE WORKSITE BENEFITS AND S3 | PO BOX 680 CLINTON, NC 28329 | CONTINENTAL AMERICAN INSURANCE COMPANY | $20K | — | $20K | 10.06% |
| MARTIN D ADAMS3 | 335 SPRUNT DR CLINTON, NC 283281175 | CONTINENTAL AMERICAN INSURANCE COMPANY | $15K | — | $15K | 7.22% |
| KATHERINE PATE3 | 332 COTTON MILL DR ZEBULON, NC 275976783 | CONTINENTAL AMERICAN INSURANCE COMPANY | $14K | — | $14K | 6.92% |
| DEBORAH D SINGER3 | 105 FAIRVIEW STREET HAVELOCK, NC 28532 | CONTINENTAL AMERICAN INSURANCE COMPANY | $12K | — | $12K | 6.02% |
| PATRICIA GAREY3 Filed as: PATRICIA A GAREY | 11285 HARRELLS HWY HARRELLS, NC 28444 | CONTINENTAL AMERICAN INSURANCE COMPANY | $9K | — | $9K | 4.61% |
| TRACEY DUTTON3 | 8631 GARLAND HIGHWAY CLINTON, NC 283280691 | CONTINENTAL AMERICAN INSURANCE COMPANY | $9K | — | $9K | 4.46% |
| TAMMY BRITT COOPER3 Filed as: TAMMY COOPER | 5164 FORTUNA DR BELVILLE, NC 284513114 | CONTINENTAL AMERICAN INSURANCE COMPANY | $9K | — | $9K | 4.28% |
| SANDRA S ADAMS3 | 335 SPRUNT DR CLINTON, NC 283281175 | CONTINENTAL AMERICAN INSURANCE COMPANY | $9K | — | $9K | 4.26% |
| TAMMY DUFFY3 | 12045 HARMONY CHURCH RD CLINTON, NC 28328 | CONTINENTAL AMERICAN INSURANCE COMPANY | $9K | — | $9K | 4.22% |
| BRIDGETTE MCLAUGHLIN3 | 103 DAWSON PLACE RD JACKSONVILLE, NC 285409275 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | — | $2K | 0.86% |
| EBENCONCEPTS COMPANY3 | 3150 NORTH ELM STE 201 GREENSBORO, NC 27408 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $20K | $5K | $25K | 19.22% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF NORTH CAR EIN 56-0894904 ADMINISTRATOR | Claims processing Service code 12 | — | $106K |
| EBENCONCEPTS COMPANY EIN 75-2966596 CONSULTANT | Other fees Service code 99 | — | $36K |
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 | 388 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 388 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 238 | $1.2M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 388 | $259K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 388 | $259K |
| Life insurance(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 388 | $461K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 159 | $130K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 159 | $130K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 238 | $1.2M |
| Other | CONTINENTAL AMERICAN INSURANCE COMPANY | 273 | $202K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 388 | — |
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.