| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTEGRA EMPLOYER HEALTH LLC5 Filed as: INTEGRA EMPLOYER HEALTH | PO BOX 1178 MATTHEWS, NC 28106 | J ALLAN HALL | $18K | $201K | $219K | — |
| INTEGRA EMPLOYER HEALTH LLC5 Filed as: INTEGRA EMPLOYER HEALTH | PO BOX 1178 MATTHEWS, NC 28106 | AETNA LIFE INSURANCE COMPANY | $4K | $46K | $51K | — |
| INTEGRA EMPLOYER HEALTH LLC5 Filed as: INTEGRA EMPLOYER HEALTH | PO BOX 1178 MATTHEWS, NC 28106 | AETNA LIFE INSURANCE COMPANY | $7K | $25K | $32K | — |
| INTEGRA EMPLOYER HEALTH LLC5 Filed as: INTEGRA EMPLOYER HEALTH | PO BOX 1178 MATTHEWS, NC 28106 | AETNA LIFE INSURANCE COMPANY | $6K | $84K | $90K | — |
| INTEGRA EMPLOYER HEALTH LLC5 Filed as: INTEGRA EMPLOYER HEALTH | PO BOX 1178 MATTHEWS, NC 28106 | VISION SERVICE PLAN | $1K | $31K | $32K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| INTEGRA EMPLOYER HEALTH LLC EIN 56-1392505 PPO PROVIDER | Contract Administrator Service code 13 | PO BOX 1178 MATTHEWS, NC 28106 | $40K |
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 | 396 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 398 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | J ALLAN HALL | 322 | $0 |
| Vision | VISION SERVICE PLAN | 204 | $0 |
| Life insurance(2 contracts) | AETNA LIFE INSURANCE COMPANY | 396 | $0 |
| Short-term disability | AETNA LIFE INSURANCE COMPANY | 225 | $0 |
| Long-term disability | AETNA LIFE INSURANCE COMPANY | 225 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 396 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.