| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CHARLES S JONES3 Filed as: CHARLES S. JONES | PO BOX 29004 GREENSBORO, NC 27429 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $46K | — | $46K | 3.85% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY, LLC | 3625 N. ELM STREET GREENSBORO, NC 27455 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 2.69% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY, LLC | 15150 NW 79TH CT. SUITE 200 MIAMI LAKES, FL 33016 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $959 | — | $959 | 1.31% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY, LLC | 9850 NW 41ST STREET SUITE 100 MIAMI, FL 33178 | AMERICAN GENERAL LIFE INSURANCE COMPANY | $2K | — | $2K | 8.00% |
| IBSI HOLDINGS INC3 Filed as: IBSI HOLDINGS, INC. | PO BOX 24337 WINSTON-SALEM, NC 27114 | AMERICAN GENERAL LIFE INSURANCE COMPANY | $1K | — | $1K | 5.00% |
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 | 121 | 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) | 121 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 222 | $1.2M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 106 | $73K |
| Vision | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 222 | $1.2M |
| Life insurance | AMERICAN GENERAL LIFE INSURANCE COMPANY | 137 | $27K |
| Short-term disability | AMERICAN GENERAL LIFE INSURANCE COMPANY | 137 | $27K |
| Long-term disability | AMERICAN GENERAL LIFE INSURANCE COMPANY | 137 | $27K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 222 | $1.2M |
| Other | AMERICAN GENERAL LIFE INSURANCE COMPANY | 137 | $27K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 222 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
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.