| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HEALTHGRAM INC4 Filed as: HEALTHGRAM | 1515 MOCKINGBIRD LANE CHARLOTTE, NC 28209 | HM LIFE INSURANCE COMPANY | $37K | — | $37K | 12.36% |
| HEALTHGRAM INC4 Filed as: HEALTHGRAM | 1515 MOCKINGBIRD LANE CHARLOTTE, NC 28209 | COMPANION LIFE INSURANCE CO. | $298 | $10 | $308 | 6.31% |
| ALLEGACY BENEFIT SOLUTIONS LLC4 Filed as: ALLEGACY BENEFIT | PO BOX 25172 WINSTON-SALEM, NC 27114 | COMPANION LIFE INSURANCE CO. | $252 | — | $252 | 5.16% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTHGRAM EIN 56-1449504 CONTRACT ADMINISTRATOR | Claims processing Service code 12 | 1515 MOCKINGBIRD LANE CHARLOTTE, NC 28209 | $32K |
| CIGNA EIN 59-1031071 MEDICAL PPO PROVIDER | Employee (plan) Service code 30 | 900 COTTAGE GROVE ROAD BLOOMFIELD, CT 06002 | $24K |
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 | 186 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 186 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | COMPANION LIFE INSURANCE CO. | 170 | $5K |
| Stop-loss / reinsurancereinsurance | HM LIFE INSURANCE COMPANY | 186 | $296K |
| Other | COMPANION LIFE INSURANCE CO. | 170 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 186 | — |
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.
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.