| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOHN W HEATH3 | PO BOX 25172 WINSTON SALEM, NC 27114 | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | $39K | — | $39K | 2.96% |
| ALLEGACY BENEFIT SOLUTIONS LLC3 Filed as: ALLEGACY BENEFIT SOLUTIONS | PO BOX 25172 WINSTON SALEM, NC 27114 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 3.21% |
| JOHN W HEATH3 | PO BOX 25172 WINSTON SALEM, NC 27114 | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | $2K | — | $2K | 4.48% |
| ALLEGACY BENEFIT SOLUTIONS LLC3 Filed as: ALLEGACY BENEFIT SOLUTIONS | PO BOX 25172 WINSTON SALEM, NC 27114 | USABLE LIFE | $5K | — | $5K | 15.02% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $3K | — | $3K | 10.01% |
| ALLEGACY BENEFIT SOLUTIONS LLC3 Filed as: ALLEGACY BENEFIT SOLUTIONS | PO BOX 25172 WINSTON SALEM, NC 27114 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $703 | — | $703 | 2.77% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $1K | — | $1K | 6.30% |
| ALLEGACY BENEFIT SOLUTIONS LLC3 Filed as: ALLEGACY BENEFIT SOLUTIONS | PO BOX 25172 WINSTON SALEM, NC 27114 | USABLE LIFE | $1K | — | $1K | 5.83% |
| ALLEGACY BENEFIT SOLUTIONS LLC3 Filed as: ALLEGACY BENEFIT SOLUTIONS | PO BOX 25172 WINSTON SALEM, NC 27114 | USABLE LIFE | $902 | — | $902 | 4.15% |
| ALLEGACY BENEFIT SOLUTIONS LLC3 Filed as: ALLEGACY BENEFIT SOLUTIONS | PO BOX 25172 WINSTON SALEM, NC 27114 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $698 | — | $698 | 3.39% |
| ALLEGACY BENEFIT SOLUTIONS LLC3 Filed as: ALLEGACY BENEFIT SOLUTIONS | PO BOX 25172 WINSTON SALEM, NC 27114 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $627 | — | $627 | 3.21% |
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 | 202 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 202 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 194 | $1.3M |
| Dental(4 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 154 | $110K |
| Vision | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 127 | $37K |
| Life insurance | USABLE LIFE | 202 | $22K |
| Short-term disability | USABLE LIFE | 164 | $32K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 194 | $1.3M |
| Other | USABLE LIFE | 202 | $22K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 202 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.