| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AON CONSULTING INC3 | PO BOX 905494 CHARLOTTE, NC 28290 | DELTA DENTAL OF NORTH CAROLINA | $6K | — | $6K | 5.01% |
| AON CONSULTING INC3 | PO BOX 905494 CHARLOTTE, NC 282905494 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 6.42% |
| AON CONSULTING INC3 | PO BOX 905494 CHARLOTTE, NC 282905494 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 3.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AON CONSULTING NONE | Consulting (general); Actuarial Service code 11 | P.O. BOX 905494 CHARLOTTE, NC 28290 | $38K |
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 NONE | Float revenue; Other services; Named fiduciary; Participant communication; Claims processing; Direct payment from the plan; Non-monetary compensation; Contract Administrator Service code 12 | — | $36K |
| VIVERAE NONE | Direct payment from the plan; Claims processing; Contract Administrator Service code 12 | 10670 N. CENTRAL EXPRESSWAY SUITE 700 DALLAS, TX 75231 | $15K |
| POYNER SPRUILL LLP NONE | Legal Service code 29 | 301 FAYETTVILLE STREET RALEIGH, NC 27601 | $15K |
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 | 200 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 206 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF NORTH CAROLINA | 266 | $120K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 341 | $54K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 201 | $34K |
| Other(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 341 | $56K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 341 | — |
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.