| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DAVID SIMAS3 | 6100 FAIRVIEW ROAD, SUITE 1000 CHARLOTTE, NC 28210 | BLUE CROSS & BLUE SHIELD OF NC | $18K | — | $18K | 1.51% |
| IRVING PYUN3 | 5400 GLENWOOD AVE STE G11 RALEIGH, NC 27612 | BLUE CROSS & BLUE SHIELD OF NC | $9K | — | $9K | 0.79% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICE USA - | 6100 FAIRVIEW ROAD, STE 1000 CHARLOTTE, NC 28210 | BLUE CROSS & BLUE SHIELD OF NC | $6K | — | $6K | 6.85% |
| THE SORIN GROUP - IRVING PYUN3 | 5400 GLENWOOD AVE STE G11 RALEIGH, NC 27612 | BLUE CROSS & BLUE SHIELD OF NC | $3K | — | $3K | 3.14% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICE USA - | 301 S COLLEGE STREET 19TH FLR CHARLOTTE, NC 28202 | BLUE CROSS & BLUE SHIELD OF NC | $5K | — | $5K | 10.00% |
| MOSIAC GROUP SERVICES3 Filed as: MOSIAC GROUP | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $2K | — | $2K | 9.72% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICE USA | 6100 FAIRVIEW ROAD, STE 1000 CHARLOTTE, NC 28210 | USABLE LIFE | $1K | — | $1K | 6.59% |
| THE SORIN INSURANCE GROUP LLC3 Filed as: THE SORIN GROUP | 5400 GLENWOOD AVE STE G11 RALEIGH, NC 27612 | USABLE LIFE | $667 | — | $667 | 3.53% |
| MOSIAC GROUP SERVICES3 Filed as: MOSIAC GROUP | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $1K | — | $1K | 9.72% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICE USA | 6100 FAIRVIEW ROAD, STE 1000 CHARLOTTE, NC 28210 | USABLE LIFE | $986 | — | $986 | 6.60% |
| THE SORIN INSURANCE GROUP LLC3 Filed as: THE SORIN GROUP | 5400 GLENWOOD AVE STE G11 RALEIGH, NC 27614 | USABLE LIFE | $528 | — | $528 | 3.53% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICE USA | PO BOX 203510 DALLAS, TX 75320 | COMMUNITY EYE CARE | $1K | — | $1K | 10.00% |
| THE SORIN INSURANCE GROUP LLC3 Filed as: THE SORIN GROUP | 1312 ANNAPOLIS DRIVE SUITE 203 RALEIGH, NC 27608 | COMMUNITY EYE CARE | $383 | — | $383 | 9.99% |
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 | 182 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 182 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS & BLUE SHIELD OF NC | 171 | $1.2M |
| Dental(2 contracts) | BLUE CROSS & BLUE SHIELD OF NC | 167 | $131K |
| Vision(2 contracts) | COMMUNITY EYE CARE | 265 | $16K |
| Life insurance | USABLE LIFE | 197 | $19K |
| Long-term disability | USABLE LIFE | 194 | $15K |
| Prescription drug | BLUE CROSS & BLUE SHIELD OF NC | 171 | $1.2M |
| Other | USABLE LIFE | 197 | $19K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 265 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.