| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DAWSON, WALLACE E3 Filed as: DAWSON, WALLACE H | 4325 LAKE BOONE TRAIL STE 200 RALEIGH, NC 27607 | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | $37K | — | $37K | 3.34% |
| IBSI HOLDINGS INC3 Filed as: IBSI HOLDINGS, INC. | — | TRUASSURE INSURANCE COMPANY | $3K | — | $3K | 5.00% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PARKWAY STE 1950 ATLANTA, GA 30339 | TRUASSURE INSURANCE COMPANY | $2K | — | $2K | 3.27% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL LLC | PO BOX 601478 CHARLOTTE, NC 282601478 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 13.65% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PARKWAY STE 1950 ATLANTA, GA 30339 | STANDARD INSURANCE COMPANY | $370 | — | $370 | 2.06% |
| IBSI HOLDINGS INC3 Filed as: IBSI HOLDING INC | 1381 OLD MILL CIRCLE #301 WINSTON SALEM, NC 27103 | STANDARD INSURANCE COMPANY | $242 | — | $242 | 1.35% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL LLC | PO BOX 203066 DALLAS, TX 75320 | STANDARD INSURANCE COMPANY | $146 | — | $146 | 0.81% |
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 | 280 | 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) | 280 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 216 | $1.1M |
| Dental | TRUASSURE INSURANCE COMPANY | 201 | $64K |
| Life insurance | STANDARD INSURANCE COMPANY | 280 | $18K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 216 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 280 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.