| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIAM RITTER3 | 138 W MAIN ST STE 200 WILLIAMSTON, NC 27892 | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | $11K | — | $11K | 1.86% |
| TRIANGLE PLANNING SERVICES3 | 138 W MAIN ST STE 200 WILLIAMSTON, NC 27892 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | — | $3K | 9.21% |
| TRIANGLE PLANNING SERVICES3 | 138 W MAIN ST STE 200 WILLIAMSTON, NC 27892 | USABLE LIFE | $924 | — | $924 | 10.00% |
| MOSAIC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $647 | — | $647 | 7.00% |
| TRIANGLE PLANNING SERVICES3 | 138 W MAIN ST STE 200 WILLIAMSTON, NC 27892 | USABLE LIFE | $624 | — | $624 | 10.00% |
| MOSAIC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $500 | — | $500 | 8.01% |
| TRIANGLE PLANNING SERVICES3 | 138 W MAIN ST ST 200 WILLIAMSTON, NC 27892 | USABLE LIFE | $188 | — | $188 | 10.00% |
| MOSAIC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $132 | — | $132 | 7.02% |
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 | 134 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 134 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 134 | $612K |
| Dental | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 134 | $612K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 83 | $35K |
| Life insurance(2 contracts) | USABLE LIFE | 121 | $15K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 83 | $35K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 83 | $35K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 134 | $612K |
| Other(3 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 134 | $620K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 134 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.