| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ERIC W. BLACK3 | 4064 COLONY ROAD, SUITE 450 CHARLOTTE, NC 28211 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $32K | $0 | $32K | 2.05% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | HARTFORD LIFE AND ACCIDENT | $19K | $2K | $21K | 16.39% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP SERVICES, LLC | 4611 UNIVERSITY DRIVE DURHAM, NC 27702 | HARTFORD LIFE AND ACCIDENT | $0 | $9K | $9K | 6.96% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 2807 CLINTON, IA 52733 | AMERITAS LIFE INSURANCE CORPORATION | $11K | $0 | $11K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 21ST FLOOR ROLLING MEADOWS, IL 60008 | AMERITAS LIFE INSURANCE CORPORATION | $0 | $858 | $858 | 0.76% |
| IBENEFIT COMMUNICATION LLC3 | 131 HILLSIDE AVENUE CHARLOTTE, NC 28209 | UNUM INSURANCE COMPANY | $3K | $271 | $4K | 11.37% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | UNUM INSURANCE COMPANY | $1K | $0 | $1K | 4.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM INSURANCE COMPANY | $0 | $116 | $116 | 0.37% |
| IBENEFIT COMMUNICATION LLC3 | 131 HILLSIDE AVENUE CHARLOTTE, NC 28209 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $125 | $2K | 8.87% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $805 | $0 | $805 | 3.57% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $50 | $50 | 0.22% |
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 | 248 | 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) | 248 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 299 | $1.6M |
| Dental | AMERITAS LIFE INSURANCE CORPORATION | 429 | $113K |
| Vision | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 299 | $1.6M |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 248 | $126K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 248 | $126K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 248 | $126K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 299 | $1.6M |
| Other(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 248 | $180K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 429 | — |
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.