| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EBENCONCEPTS COMPANY3 | 3150 NORTH ELM STE 201 GREENSBORO, NC 27408 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $26K | — | $26K | 13.56% |
| EBENCONCEPTS COMPANY3 Filed as: EBENCONCEPTS COMPANY, INC. | 3150 NORTH ELM STE 201 GREENSBORO, NC 27408 | THE GUARDIAN LIFE INSURANCE COMPANY | $903 | — | $903 | 10.68% |
| EBENCONCEPTS COMPANY3 | 3150 NORTH ELM STE 201 GREENSBORO, NC 27408 | MUTUAL OF OMAHA INSURANCE COMPANY | $500 | — | $500 | 15.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EBENCONCEPTS COMPANY EIN 75-2966596 CONSULTANT | Other fees Service code 99 | — | $50K |
| BLUE CROSS BLUE SHIELD NORTH CAROLI EIN 56-0894904 TPA | Claims processing; Contract Administrator Service code 12 | — | $30K |
| MUTUAL OF OMAHA INSURANCE COMPANY EIN 47-0246511 THIRD PARTY ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $5K |
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 | 499 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 499 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 180 | $589K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY | 175 | $8K |
| Vision | COMMUNITY EYE CARE | 499 | $25K |
| Life insurance(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 182 | $202K |
| Short-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 182 | $199K |
| Long-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 182 | $199K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 180 | $589K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 180 | $589K |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 182 | $202K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 499 | — |
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."
No prospect flags tripped on this filing.