| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: SENN DUNN A MARSH & MCLENNAN AGENCY | 3625 N ELM ST #200 GREENSBORO, NC 274552604 | AMERITAS LIFE INSUARNCE CORP. | $37K | — | $37K | 12.00% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 5145 GREENVILLE, SC 296065145 | AMERITAS LIFE INSUARNCE CORP. | — | $6K | $6K | 1.89% |
| MARSH & MCLENNAN AGENCY LLC3 | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $12K | — | $12K | 12.00% |
| MARSH & MCLENNAN AGENCY LLC3 | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9K | — | $9K | 12.00% |
| MARSH & MCLENNAN AGENCY LLC3 | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $12K | — | $12K | 17.00% |
| MARSH & MCLENNAN AGENCY LLC3 | 5605 CARNEGIE BLVD STE 300 CHARLOTTE, NC 28209 | HARTFORD LIFE AND ACCIDENT | $9K | — | $9K | 18.34% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP SERVICES, LLC | 4611 UNIVERSITY DR DURHAM, NC 27702 | HARTFORD LIFE AND ACCIDENT | — | $366 | $366 | 0.77% |
| MARSH & MCLENNAN AGENCY LLC3 | 5605 CARNEGIE BLVD STE 300 CHARLOTTE, NC 28209 | HARTFORD LIFE AND ACCIDENT | $7K | — | $7K | 18.37% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP SERVICES, LLC | 4611 UNIVERSITY DR DURHAM, NC 27702 | HARTFORD LIFE AND ACCIDENT | — | $2K | $2K | 6.43% |
| MARSH & MCLENNAN AGENCY LLC3 | 5605 CARNEGIE BLVD STE 300 CHARLOTTE, NC 28209 | HARTFORD LIFE AND ACCIDENT | $6K | — | $6K | 18.30% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP SERVICES, LLC | 4611 UNIVERSITY DR DURHAM, NC 28209 | HARTFORD LIFE AND ACCIDENT | — | $198 | $198 | 0.63% |
| MARSH & MCLENNAN AGENCY LLC3 | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 17.01% |
| MARSH & MCLENNAN AGENCY LLC3 | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $734 | — | $734 | 12.00% |
| MARSH & MCLENNAN AGENCY LLC3 | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $147 | — | $147 | 12.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 CLAIMS ADMINISTRATOR | Contract Administrator; Non-monetary compensation; Named fiduciary; Participant communication; Claims processing; Other services; Float revenue; Direct payment from the plan Service code 12 | — | $83K |
| CIGNA | Float revenue; Other services; Named fiduciary; Participant communication; Claims processing; Direct payment from the plan; Non-monetary compensation; Contract Administrator Service code 12 | — | $0 |
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 | 387 | 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) | 387 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AMERITAS LIFE INSUARNCE CORP. | 822 | $310K |
| Vision | AMERITAS LIFE INSUARNCE CORP. | 822 | $310K |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $80K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $100K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $75K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 622 | $429K |
| Other(5 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 165 | $126K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 822 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.