| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BURCHFIELD INSURANCE GROUP INC3 Filed as: BURCHFIELD INSURANCE GROUP | PO BOX 1762 CONCORD, NC 28026 | DELTA DENTAL OF NORTH CAROLINA | $10K | — | $10K | 11.10% |
| IBSI HOLDINGS INC3 Filed as: IBSI HOLDINGS INC. | PO BOX 24337 WINSTON SALEM, NC 27114 | DELTA DENTAL OF NORTH CAROLINA | $5K | — | $5K | 5.55% |
| BURCHFIELD INSURANCE GROUP INC3 | PO BOX 3414 CONCORD, NC 28025 | USABLE LIFE | $3K | — | $3K | 10.00% |
| MOSIAC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $2K | — | $2K | 5.00% |
| BURCHFIELD INSURANCE GROUP INC3 Filed as: BURCHFIELD INSURANCE AGENCY | PO BOX 3414 CONCORD, NC 28025 | COMMUNITY EYE CARE | $2K | — | $2K | 10.00% |
| BURCHFIELD INSURANCE GROUP INC3 | PO BOX 3414 CONCORD, NC 28025 | USABLE LIFE | $1K | — | $1K | 10.00% |
| MOSAIC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $579 | — | $579 | 5.00% |
| BURCHFIELD INSURANCE GROUP INC3 | PO BOX 3414 CONCORD, NC 28025 | USABLE LIFE | $1K | — | $1K | 10.00% |
| MOSIAC GROUP SERVICES3 | P.O. BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $514 | — | $514 | 5.00% |
| BURCHFIELD INSURANCE GROUP INC3 | PO BOX 3414 CONCORD, NC 28025 | USABLE LIFE | $118 | — | $118 | 15.03% |
| MOSIAC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $78 | — | $78 | 9.94% |
| BURCHFIELD INSURANCE GROUP INC3 | PO BOX 3414 CONCORD, NC 28025 | USABLE LIFE | $13 | — | $13 | 15.12% |
| MOSIAC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $9 | — | $9 | 10.47% |
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 | 185 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 185 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 282 | $427K |
| Dental | DELTA DENTAL OF NORTH CAROLINA | 241 | $94K |
| Vision | COMMUNITY EYE CARE | 258 | $17K |
| Life insurance(2 contracts) | USABLE LIFE | 185 | $11K |
| Short-term disability | USABLE LIFE | 185 | $12K |
| Long-term disability | USABLE LIFE | 185 | $33K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 282 | $427K |
| Other(2 contracts) | USABLE LIFE | 185 | $10K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 282 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.