| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RUSSELL CARTER3 | 2501 BLUE RIDGE ROAD SUITE 250 RALEIGH, NC 27607 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $43K | — | $43K | 1.47% |
| JAMES A SCOTT & SON INC3 Filed as: JAMES A SCOTT & SON | 628 GREEN VALLEY ROAD GREENSBORO, NC 27408 | DELTA DENTAL OF NORTH CAROLINA | $21K | — | $21K | 7.37% |
| JAMES A SCOTT & SON INC3 Filed as: JAMES A SCOTT & SON | 1301 OLD GRAVES MILL ROAD LYNCHBURG, VA 24502 | USABLE LIFE | $6K | — | $6K | 10.00% |
| MOSAIC GROUP SERVICES3 | P.O. BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $4K | — | $4K | 7.00% |
| JAMES A SCOTT & SON INC3 Filed as: JAMES A SCOTT & SON | 1301 OLD GRAVES MILL ROAD LYNCHBURG, VA 24502 | USABLE LIFE | $9K | — | $9K | 15.00% |
| MOSAIC GROUP SERVICES3 | P.O. BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $6K | — | $6K | 10.00% |
| JAMES A SCOTT & SON INC3 Filed as: JAMES A SCOTT & SON | 1301 OLD GRAVES MILL ROAD LYNCHBURG, VA 24502 | USABLE LIFE | $5K | — | $5K | 10.00% |
| MOSAIC GROUP SERVICES3 | P.O. BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $4K | — | $4K | 7.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL SOUTHEAST | 2430 MALL DRIVE SUITE 280 CHARLESTON, SC 29406 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | — | $4K | 10.10% |
| JAMES A SCOTT & SON INC3 Filed as: JAMES A SCOTT & SON | P.O. BOX 603468 CHARLOTTE, NC 28260 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $1K | $3K | 7.29% |
| JAMES A SCOTT & SON INC3 Filed as: JAMES A SCOTT & SON | 2501 BLUE RIDGE ROAD SUITE 250 RALEIGH, NC 27607 | EYEMED | $4K | — | $4K | 10.96% |
| JAMES A SCOTT & SON INC3 Filed as: JAMES A SCOTT & SON | 1301 OLD GRAVES MILL ROAD LYNCHBURG, VA 24502 | USABLE | $3K | — | $3K | 10.00% |
| MOSAIC GROUP SERVICES3 | P.O. BOX 2291 DURHAM, NC 27702 | USABLE | $2K | — | $2K | 7.00% |
| JAMES A SCOTT & SON INC3 Filed as: JAMES A SCOTT & SON | P.O. BOX 603438 CHARLOTTE, NC 28260 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $981 | $2K | 23.04% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL SOUTHEAST | 2430 MALL DRIVE CHARLESTON, SC 29406 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $116 | — | $116 | 1.09% |
| JAMES A SCOTT & SON INC3 Filed as: JAMES A SCOTT & SON | 1301 OLD GRAVES MILL ROAD LYNCHBURG, VA 24502 | USABLE LIFE | $1K | — | $1K | 15.00% |
| MOSAIC GROUP SERVICES3 | P.O. BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $892 | — | $892 | 10.00% |
| JAMES A SCOTT & SON INC3 Filed as: JAMES A SCOTT & SON | P.O. BOX 603438 CHARLOTTE, NC 28260 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $127 | $63 | $190 | 11.97% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL SOUTHEAST | 2430 MALL DRIVE SUITE 280 CHARLESTON, SC 29406 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $108 | — | $108 | 6.81% |
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 | 204 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 211 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 435 | $2.9M |
| Dental | DELTA DENTAL OF NORTH CAROLINA | 449 | $286K |
| Vision | EYEMED | 455 | $38K |
| Life insurance(2 contracts, 2 carriers) | USABLE LIFE | 207 | $91K |
| Short-term disability | USABLE LIFE | 146 | $63K |
| Long-term disability(4 contracts, 2 carriers) | USABLE LIFE | 206 | $108K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 435 | $2.9M |
| Other(3 contracts, 3 carriers) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 435 | $2.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 455 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.