| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIANA M MASON3 | PO BOX 10489 LYNCHBURG, VA 24506 | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | $22K | — | $22K | 2.06% |
| JAMES A SCOTT & SON INC3 | 2501 BLUE RIDGE ROAD SUITE 250 RALEIGH, NC 27607 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | — | $4K | 9.36% |
| WATCHTOWER BENEFITS, LLC3 Filed as: WATCHTOWER BENEFITS LLC DBA THREEFL | 306 W ERIE STREET SUITE 300 CHICAGO, IL 60654 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | — | $1K | 2.51% |
| JAMES A SCOTT & SON INC3 | PO BOX 603438 CHARLOTTE, NC 28260 | HARTFORD LIFE AND ACCIDENT | $5K | $649 | $6K | 14.20% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP SERVICES LLC | 4611 UNIVERSITY DRIVE DURHAM, NC 27702 | HARTFORD LIFE AND ACCIDENT | — | $3K | $3K | 7.00% |
| JOHN A SCOTT & SON INC DBA SCOTT IN3 | 2501 BLUE RIDGE ROAD SUITE 250 RALEIGH, NC 27607 | COMMUNITY EYE CARE | $685 | — | $685 | 9.99% |
| THE CASON GROUP INC3 Filed as: THE CASON GROUP | PO BOX 11229 COLUMBIA, SC 29211 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $285 | — | $285 | 5.11% |
| JAMES A SCOTT & SON INC3 | PO BOX 603438 CHARLOTTE, NC 28260 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $277 | — | $277 | 4.97% |
| THE WORKSITE GROUP LLC3 Filed as: WORKSITE SERVICES INC | PO BOX 327 GARNER, NC 27529 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $22 | — | $22 | 0.39% |
| JAMES A SCOTT & SON INC3 | PO BOX 603438 CHARLOTTE, NC 28260 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $240 | — | $240 | 4.48% |
| THE CASON GROUP INC3 Filed as: THE CASON GROUP | PO BOX 11229 COLUMBIA, SC 29211 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $231 | — | $231 | 4.31% |
| THE WORKSITE GROUP LLC3 Filed as: WORKSITE SERVICES INC | PO BOX 327 GARNER, NC 27529 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $23 | — | $23 | 0.43% |
| JAMES A SCOTT & SON INC3 | PO BOX 603438 CHARLOTTE, NC 28260 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $242 | — | $242 | 5.07% |
| THE CASON GROUP INC3 | PO BOX 11229 COLUMBIA, SC 29211 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $217 | — | $217 | 4.54% |
| THE WORKSITE GROUP LLC3 Filed as: WORKSITE SERVICES INC | PO BOX 327 GARNER, NC 27529 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $60 | — | $60 | 1.26% |
| CARDWELL TIMOTHY R3 | 2111 LAMBETH FARM LANE KERNERSVILLE, NC 27284 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1 | — | $1 | 0.02% |
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 | 123 | 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) | 123 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 90 | $1.1M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 144 | $42K |
| Vision | COMMUNITY EYE CARE | 104 | $7K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 123 | $41K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 123 | $41K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 123 | $41K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 90 | $1.1M |
| Other(4 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 123 | $57K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 144 | — |
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.