| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIAM F SALMON3 Filed as: WILLIAM SALMON | 2443 LYNN ROAD, SUITE 208 RALEIGH, NC 27612 | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | $35K | — | $35K | 19.77% |
| JOHN MCDONNELL3 | 2443 LYNN ROAD, SUITE 208 RALEIGH, NC 27612 | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | $3K | — | $3K | 1.70% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH USA, INC. | 2443 LYNN ROAD, SUITE 208 RALEIGH, NC 27612 | USABLE LIFE | $425 | — | $425 | 9.14% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $272 | — | $272 | 5.85% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BCBS OF NC EIN 56-0894904 ADMINISTRATOR | Claims processing; Insurance agents and brokers Service code 12 | 2443 LYNN ROAD, SUITE 208 RALEIGH, NC 27612 | $74K |
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 | 178 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 178 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 137 | $179K |
| Vision | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 137 | $179K |
| Life insurance | USABLE LIFE | 178 | $5K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 137 | $179K |
| Other | USABLE LIFE | 178 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 178 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.