| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOHN W HEATH3 | PO BOX 25172 WINSTON SALEM, NC 27114 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $38K | $1K | $39K | 2.74% |
| ALLEGACY BENEFIT SOLUTIONS LLC3 | PO BOX 25172 WINSTON SALEM, NC 27114 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 3.16% |
| ALLEGACY BENEFIT SOLUTIONS LLC3 | PO BOX 25172 WINSTON SALEM, NC 27114 | USABLE LIFE | $5K | — | $5K | 15.00% |
| MOSAIC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $3K | — | $3K | 10.00% |
| ALLEGACY BENEFIT SOLUTIONS LLC3 | PO BOX 25172 WINSTON SALEM, NC 27114 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $893 | — | $893 | 2.92% |
| ALLEGACY BENEFIT SOLUTIONS LLC | PO BOX 25172 WINSTON SALEM, NC 27114 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $656 | — | $656 | 3.31% |
| ALLEGACY BENEFIT SOLUTIONS LLC3 | PO BOX 25172 WINSTON SALEM, NC 27114 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $715 | — | $715 | 3.64% |
| ALLEGACY BENEFIT SOLUTIONS LLC3 | PO BOX 25172 WINSTON SALEM, NC 27114 | USABLE LIFE | $2K | — | $2K | 9.46% |
| MOSAIC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $1K | — | $1K | 6.02% |
| JOHN W HEATH3 | PO BOX 25172 WINSTON SALEM, NC 27114 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $2K | — | $2K | 9.23% |
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 | 201 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 201 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 198 | $1.4M |
| Dental(4 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 147 | $113K |
| Vision | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 129 | $17K |
| Life insurance | USABLE LIFE | 201 | $19K |
| Short-term disability | USABLE LIFE | 180 | $32K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 198 | $1.4M |
| Other | USABLE LIFE | 201 | $19K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 201 | — |
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.