| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JAMES ALEXANDER3 | 12 FEDERAL ST STE 405 PITTSBURGH, PA 15212 | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | $22K | — | $22K | 2.31% |
| WENDY PACE3 | PO BOX 33789 CHARLOTTE, NC 28233 | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | $4K | — | $4K | 0.38% |
| FIRST NATIONAL INSURANCE AGENCY3 Filed as: FIRST NATIONAL INSURANCE AGENCY LLC | PO BOX 6369 HERMITAGE, PA 16148 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | — | $5K | 9.21% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 1213 W MOREHEAD STREET STE 410 CHARLOTTE, NC 28208 | METROPOLITAN LIFE INSURANCE COMPANY | $436 | — | $436 | 0.82% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 16253 COLLECTION CENTER DR 40 W MADISON 4TH FLR BANK OF AMERIC CHICAGO, IL 60693 | METROPOLITAN LIFE INSURANCE COMPANY | — | $44 | $44 | 0.08% |
| FIRST NATIONAL INSURANCE AGENCY3 Filed as: FIRST NATIONAL INSURANCE AGENCY LLC | 626 WASHINGTON PLACE PITTSBURGH, PA 15219 | USABLE LIFE | $2K | — | $2K | 9.25% |
| MOSAIC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $2K | — | $2K | 7.35% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 2158 RIVERSIDE, CA 92516 | USABLE LIFE | $181 | — | $181 | 0.79% |
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 | 135 | 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) | 135 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 159 | $954K |
| Dental | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 159 | $954K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 113 | $53K |
| Life insurance | USABLE LIFE | 135 | $23K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 113 | $53K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 113 | $53K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 159 | $954K |
| Other | USABLE LIFE | 135 | $23K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 159 | — |
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.