| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WELLS FARGO INSURANCE SERVICES3 | 6100 FAIRVIEW ROAD, SUITE 1000 CHARLOTTE, NC 28210 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $50K | — | $50K | 2.44% |
| WELLS FARGO INSURANCE SERVICES3 | 600 HIGHWAY 169 SOUTH, SUITE 1200 SAINT LOUIS PARK, MN 55426 | AETNA LIFE INSURANCE COMPANY | $11K | — | $11K | 4.58% |
| WELLS FARGO INSURANCE SERVICES3 | 301 SOUTH COLLEGE STREET 19TH FLOOR CHARLOTTE, NC 28202 | USABLE LIFE | $13K | — | $13K | 11.02% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP | 4605 UNIVERSITY DRIVE DURHAM, NC 27707 | USABLE LIFE | $8K | — | $8K | 6.41% |
| WELLS FARGO INSURANCE SERVICES3 | 6100 FAIRVIEW ROAD, SUITE 1400 CHARLOTTE, NC 28210 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $2K | — | $2K | 9.94% |
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 | 303 | 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) | 303 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 466 | $2.0M |
| Dental | AETNA LIFE INSURANCE COMPANY | 551 | $232K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 212 | $21K |
| Life insurance | USABLE LIFE | 303 | $121K |
| Short-term disability | USABLE LIFE | 303 | $121K |
| Long-term disability | USABLE LIFE | 303 | $121K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 466 | $2.0M |
| Other | USABLE LIFE | 303 | $121K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 551 | — |
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."
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.