| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JAMES A HARDISON V3 Filed as: JAMES HARDISON V | 51 E 4TH STREET APT 704 WINSTON-SALEM, NC 27101 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $4K | — | $4K | 0.38% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, LLC | PO BOX 896620 CHARLOTTE, NC 28289 | HARTFORD LIFE AND ACCIDENT | $8K | $1K | $9K | 7.61% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP SERVICES, LLC | 4611 UNIVERSITY DR DURHAM, NC 27702 | HARTFORD LIFE AND ACCIDENT | — | $7K | $7K | 5.68% |
| THE BENEFIT COMPANY INC3 Filed as: THE BENEFIT COMPANY, INC. | PO BOX 211486 COLUMBIA, SC 29221 | HARTFORD LIFE AND ACCIDENT | $1K | — | $1K | 1.07% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, LLC | LOCKBOX # 896620 5130 PARKWAY PLAZA BLVD CHARLOTTE, NC 282171964 | PRINCIPAL LIFE INSURANCE COMPANY | $7K | — | $7K | 6.98% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF NORTH CAROLINA, LLC | 530 N TRADE ST STE 302 WINSTON-SALEM, NC 271012957 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | — | $3K | 3.02% |
| THE BENEFIT COMPANY INC3 Filed as: THE BENEFIT COMPANY, INC. | PO BOX 211486 COLUMBIA, SC 292216486 | PRINCIPAL LIFE INSURANCE COMPANY | — | $2K | $2K | 2.25% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 3150 S MAIN ST HARRISONBURG, VA 228012670 | PRINCIPAL LIFE INSURANCE COMPANY | — | $853 | $853 | 0.88% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES INC. | 7701 AIRPORT CENTER DRIVE STE 210 GREENSBORO, NC 274099047 | PRINCIPAL LIFE INSURANCE COMPANY | — | $448 | $448 | 0.46% |
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 | 120 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 123 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 167 | $1.1M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 194 | $97K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 194 | $97K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 153 | $119K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 153 | $119K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 153 | $119K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 167 | $1.1M |
| Other(2 contracts, 2 carriers) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 167 | $1.2M |
| 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.