| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DALE K. MOORE3 | PO BOX 220748 CHARLOTTE, NC 28222 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $37K | — | $37K | 4.82% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 330 MADISON AVENUE, 7TH FLOOR NEW YORK, NY 10017 | AMERICAN GENERAL LIFE INSURANCE COMPANY | $7K | — | $7K | 10.00% |
| IBSI HOLDINGS INC3 Filed as: IBSI HOLDING INC. | PO BOX 24337 WINSTON SALEM, NC 27114 | AMERICAN GENERAL LIFE INSURANCE COMPANY | $3K | — | $3K | 5.08% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 400 HIGHWAY 169 SOUTH, 8TH FLOOR SAINT LOUIS PARK, MN 55426 | USABLE LIFE | $3K | — | $3K | 7.97% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP SERVICE | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $3K | — | $3K | 7.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 601478 CHARLOTTE, NC 28260 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $4K | $414 | $5K | 16.41% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 203491 DALLAS, TX 75320 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $7K | — | $7K | 41.85% |
| THE CASON GROUP INC3 Filed as: THE CASON GROUP | PO BOX 11229 COLUMBIA, SC 29211 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3K | — | $3K | 18.40% |
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 | 143 | 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) | 143 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 191 | $794K |
| Dental | AMERICAN GENERAL LIFE INSURANCE COMPANY | 120 | $69K |
| Life insurance(2 contracts, 2 carriers) | USABLE LIFE | 143 | $73K |
| Short-term disability | USABLE LIFE | 143 | $44K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 191 | $776K |
| Other(3 contracts, 3 carriers) | USABLE LIFE | 143 | $91K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 191 | — |
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.