| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT S FUSSELL3 Filed as: ROBERT A. SINK | 2ND FLOOR 275 4020 WESTCHASE BLVD RALEIGH, NC 27607 | THE NORTHWESTERN MUTUAL LIFE INSURANCE COMPANY | $2K | $558 | $3K | 1.56% |
| ROBERT S FUSSELL3 Filed as: ROBERT S. FUSSELL | 2ND FLOOR 275 4020 WESTCHASE BLVD RALEIGH, NC 27607 | THE NORTHWESTERN MUTUAL LIFE INSURANCE COMPANY | $2K | $558 | $3K | 1.56% |
| CAROLINA CONDREY GROUP3 Filed as: CAROLINA CONDREY GRP | 2ND FLOOR 275 4020 WESTCHASE BLVD RALEIGH, NC 27607 | THE NORTHWESTERN MUTUAL LIFE INSURANCE COMPANY | $1K | $168 | $1K | 0.65% |
| BANYAN CONSULTING GROUP INC3 Filed as: BANYAN CONSULTING GROUP INC. | 333 N. GREENE STREET STE 101 GREENSBORO, NC 27401 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $7K | $4K | $11K | 14.70% |
| HCW EMPLOYEE BENEFIT SERVICES, LLC3 Filed as: HCW EMPLOYEE BENEFIT SERVICES | 4819 EMPEROR BLVD STE 200 DURHAM, NC 27703 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 1.67% |
| EBENCONCEPTS COMPANY3 | 921-C S MCPHERSON CHURCH FAYETTEVILLE, NC 28303 | USABLE LIFE | $448 | — | $448 | 7.51% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $348 | — | $348 | 5.83% |
| HCW EMPLOYEE BENEFIT SERVICES, LLC3 Filed as: HCW EMPLOYEE BENEFIT SERVICES | 4819 EMPEROR BLVD STE 200 DURHAM, NC 27703 | USABLE LIFE | $100 | — | $100 | 1.68% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF NC EIN 56-0894904 NONE | Claims processing Service code 12 | — | $479K |
| ALLISON C. TOLKSDORF NONE | Insurance agents and brokers Service code 22 | 921-C S. MCPHERSON CHURCH FAYETTEVILLE, NC 28303 | $12K |
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 | 163 | 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) | 163 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 164 | $82K |
| Short-term disability | THE NORTHWESTERN MUTUAL LIFE INSURANCE COMPANY | 163 | $190K |
| Long-term disability | THE NORTHWESTERN MUTUAL LIFE INSURANCE COMPANY | 163 | $190K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 164 | $82K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 164 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
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.