| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JAMES A SCOTT & SON INC3 | PO BOX 603438 CHARLOTTE, NC 28260 | HARTFORD LIFE AND ACCIDENT | $13K | — | $13K | 2.56% |
| MARSH & MCLENNAN AGENCY LLC3 | 100 FRONT ST STE 800 WORCESTER, MA 01608 | HARTFORD LIFE AND ACCIDENT | $0 | $1K | $1K | 0.23% |
| JAMES A SCOTT & SON INC3 | PO BOX 603438 CHARLOTTE, NC 28260 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $0 | $921 | $921 | 3.09% |
| C2 CENTRIC LLC3 | 11740 SW 68TH PARKWAY, SUITE 2 PORTLAND, OR 97223 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $28 | $0 | $28 | 0.09% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF NC EIN 56-0894904 CLAIMS PROCESSOR | Claims processing; Insurance agents and brokers Service code 12 | 4615 UNIVERSITY DR DURHAM, NC 27707 | $317K |
| FLORES AND ASSOCIATES EIN 56-1542307 NONE | Legal Service code 29 | 1218 CHURCH ST CHARLOTTE, NC 28203 | $10K |
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 | 889 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 889 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 1,305 | $0 |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 889 | $30K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 839 | $508K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 839 | $508K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 839 | $508K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 1,305 | $0 |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 1,305 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,305 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.