| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WALLACE H DAWSON3 Filed as: WALLACE E DAWSON | 4235 LAKE BOONE SUITE 220 RALEIGH, NC 27607 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $38K | $0 | $38K | 3.07% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | USABLE LIFE | $6K | $945 | $7K | 13.06% |
| MOSAIC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $3K | $0 | $3K | 6.08% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| WALLACE E DAWSON BROKER | Insurance brokerage commissions and fees Service code 53 | 4235 LAKE BOONE SUITE 220 RALEIGH, NC 27607 | $38K |
| DIGITAL INSURANCE LLC BROKER | Insurance brokerage commissions and fees Service code 53 | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | $7K |
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 | 209 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 209 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 209 | $1.2M |
| Dental | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 209 | $1.2M |
| Life insurance | USABLE LIFE | 166 | $52K |
| Short-term disability | USABLE LIFE | 166 | $52K |
| Long-term disability | USABLE LIFE | 166 | $52K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 209 | $1.2M |
| Other | USABLE LIFE | 166 | $52K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 209 | — |
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.