| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HEALTHGTRAM, INC.3 | 8731 RED OAK BLVD CHARLOTTE, NC 28217 | HM LIFE INSURANCE COMPANY | — | — | $0 | 0.00% |
| HEALTHGRAM INC3 Filed as: HEALTHGRAM, INC. | 8731 RED OAK BLVD CHARLOTTE, NC 28217 | HCC LIFE INSURANCE COMPANY | $4K | — | $4K | 2.00% |
| HCC LIFE INSURANCE COMPANY3 Filed as: HCC LIFE INSURANCE COMOPANY | 225 TOWNPARK DR. SUITE 350 KENNESAW, GA 30144 | HCC LIFE INSURANCE COMPANY | $0 | — | $0 | 0.00% |
| IBSI HOLDINGS INC3 Filed as: IBSI HOLDINGS, INC. | 1381 OLD MILL CIRCLE SUITE 301 WINSTON-SALEM, NC 27103 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $6K | $0 | $6K | 20.00% |
| IBSI HOLDINGS INC3 Filed as: IBSI HOLDINGS, INC. | 1381 OLD MILL CIRCLE, STE 301 WINSTON-SALEM, NC 27103 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $0 | $3K | 10.00% |
| IBSI HOLDINGS INC3 | 1381 OLD MILL CIRCLE SUITE 301 WINSTON-SALEM, NC 27103 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $0 | $2K | 20.00% |
| IBSI HOLDINGS INC3 Filed as: IBSI HOLDINGS, INC. | 1381 OLD MILL CIRCLE SUITE 301 WINSTON-SALEM, NC 27103 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $0 | $2K | 20.00% |
| IBSI HOLDINGS INC3 Filed as: IBSI HOLDINGS, INC. | 1381 OLD MILL CIRCLE SUITE 301 WINSTON-SALEM, NC 27103 | RELIANCE STANDARD LIFE INSURACE COMPANY | $64 | $0 | $64 | 9.94% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTHGRAM, INC. EIN 56-1449504 THIRD PARTY ADMINIS. | Contract Administrator; Plan Administrator Service code 13 | 8731 RED OAK BLVD CHARLOTTE, NC 28217 | $69K |
| CIGNA CORPORATION EIN 59-1031071 INSURANCE PROVIDER | Claims processing; Insurance services Service code 12 | — | $34K |
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 | 418 | 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) | 418 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | RELIANCE STANDARD LIFE INSURANCE COMPANY | 404 | $27K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 418 | $30K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 307 | $11K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 319 | $10K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | HM LIFE INSURANCE COMPANY | 394 | $407K |
| Other(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 418 | $31K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 418 | — |
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."
No prospect flags tripped on this filing.