| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIAM L MICHELSEN3 | 1901 ROXBOROUGH ROAD SUITE 300 CHARLOTTE, NC 28211 | BLUE CROSS & BLUE SHIELD OF NORTH CAROLINA | $24K | $0 | $24K | 3.30% |
| MATTHEW A ESTRELA3 | 751 CORPORATE CENTER DR STE 12 RALEIGH, NC 276074873 | BLUE CROSS & BLUE SHIELD OF NORTH CAROLINA | $6K | $0 | $6K | 0.79% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX INSURANCE AGENCY INC | 225 KENNETH DR ROCHESTER, NY 146234277 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | $565 | $3K | 6.06% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP SERVICES LLC | PO BOX 2291 DURHAM, NC 277022291 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | $0 | $2K | 3.95% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 751 CORPORATE CENTER DR STE 12 RALEIGH, NC 276074873 | PRINCIPAL LIFE INSURANCE COMPANY | $668 | $0 | $668 | 1.19% |
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 | 136 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 136 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS & BLUE SHIELD OF NORTH CAROLINA | 63 | $717K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 136 | $56K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 136 | $56K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 136 | $56K |
| Prescription drug | BLUE CROSS & BLUE SHIELD OF NORTH CAROLINA | 63 | $717K |
| Other | BLUE CROSS & BLUE SHIELD OF NORTH CAROLINA | 63 | $717K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 136 | — |
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.