| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTL MIDWEST LIMITED | 628 GREEN VALLEY ROAD STE 300 GREENSBORO, NC 27408 | HARTFORD LIFE AND ACCIDENT | $9K | — | $9K | 10.00% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP SERVICES, LLC | 4611 UNIVERSITY DR DURHAM, NC 27702 | HARTFORD LIFE AND ACCIDENT | — | $6K | $6K | 7.00% |
| CLC FINANCIAL SERVICES GROUP, LLC3 | 4910 FAYETTEVILLE RD LUMBERTON, NC 28358 | HARTFORD LIFE AND ACCIDENT | $2 | — | $2 | 0.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 939 BURLINGTON, NC 27216 | DELTA DENTAL OF NORTH CAROLINA | $7K | — | $7K | 9.26% |
| CLC FINANCIAL SERVICES GROUP, LLC3 | 4910 FAYETTEVILLE RD LUMBERTON, NC 28358 | DELTA DENTAL OF NORTH CAROLINA | $626 | — | $626 | 0.79% |
| VARIOUS - SEE ATTACHED3 Filed as: VARIOUS-SEE ATTACHED | — | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11K | $2K | $12K | 16.37% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 751 CORPORATE CENTER DRIVE # 120 RALEIGH, NC 27607 | COMMUNITY EYE CARE | $2K | — | $2K | 10.00% |
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 | 138 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 138 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF NORTH CAROLINA | 189 | $79K |
| Vision | COMMUNITY EYE CARE | 194 | $16K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 133 | $88K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 133 | $88K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 133 | $88K |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 133 | $164K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 194 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.