| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INSURANCE SVC OF ASHEVILLE INC3 | 408 EXECUTIVE PARK BLDG 3 ASHEVILLE, NC 28801 | HCC LIFE INSURANCE COMPANY | $6K | — | $6K | 1.00% |
| COLTON GROOME BENEFIT ADVISORS, LLC3 | 1127B HENDERSONVILLE RD ASHEVILLE, NC 28803 | SUN LIFE ASSURANCE COMPANY OF CANADA | $11K | — | $11K | 9.08% |
| COLTON GROOME BENEFIT ADVISORS, LLC3 | 1127B HENDERSONVILLE RD ASHEVILLE, NC 28803 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 7.13% |
| INSURANCE SVC OF ASHEVILLE INC3 | PO BOX 530 ASHEVILLE, NC 28802 | COMMUNITY EYE CARE | $3K | — | $3K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MEDCOST BENEFIT SERVICES EIN 56-2056821 NONE | Contract Administrator Service code 13 | 165 KIMEL PARK DR. WINSTON-SALEM, NC 27103 | $141K |
| INSURANCE SERVICES OF ASHEVILLE INC EIN 56-0668722 NONE | Insurance agents and brokers Service code 22 | 408 EXECUTIVE PARK BLDG 3 ASHEVILLE, NC 28801 | $9K |
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 | 475 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 475 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HCC LIFE INSURANCE COMPANY | 440 | $587K |
| Dental | HCC LIFE INSURANCE COMPANY | 440 | $587K |
| Vision | COMMUNITY EYE CARE | 543 | $35K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 475 | $39K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 468 | $118K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 468 | $118K |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 475 | $39K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 543 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.