| 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 | $6K | $32K | 16.93% |
| UNITED OF OMAHA LIFE INSURANCE CO5 | MUTUAL OF OMAHA PLAZA OMAHA, NE 68175 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $4K | $4K | 2.32% |
| EBENCONCEPTS COMPANY3 Filed as: EBENCONCEPTS COMPANY, INC. | 3150 NORTH ELM STE 201 GREENSBORO, NC 27408 | THE GUARDIAN LIFE INSURANCE COMPANY | $810 | — | $810 | 10.39% |
| EBENCONCEPTS COMPANY3 | 3150 NORTH ELM STE 201 GREENSBORO, NC 27408 | MUTUAL OF OMAHA INSURANCE COMPANY | $510 | $151 | $661 | 19.42% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD NORTH CAROLI EIN 56-0894904 TPA | Contract Administrator; Claims processing Service code 12 | — | $69K |
| EBENCONCEPTS COMPANY EIN 75-2966596 CONSULTANT | Other fees Service code 99 | — | $50K |
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 | 461 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 461 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 168 | $611K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY | 162 | $8K |
| Vision | COMMUNITY EYE CARE | 461 | $36K |
| Life insurance(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 174 | $198K |
| Short-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 174 | $195K |
| Long-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 174 | $195K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 168 | $611K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 168 | $611K |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 174 | $198K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 461 | — |
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.