| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTEGRA EMPLOYER HEALTH, LLC D/B/A/5 | PO BOX 1178 MATTHEWS, NC 28106 | COMPANION LIFE INSURANCE COMPANY | $34K | — | $34K | 12.93% |
| CONTEXT BENEFIT ADVISORS, LLC3 | 2425 CROWN POING EXECUTIVE DRIVE CHARLOTTE, NC 28227 | COMPANION LIFE INSURANCE COMPANY | $9K | — | $9K | 3.28% |
| CONTEXT BENEFIT ADVISORS, LLC3 | 2425 CROWN POING EXECUTIVE DRIVE CHARLOTTE, NC 28227 | DELTA DENTAL OF NORTH CAROLINA | $14K | $2K | $15K | 15.30% |
| CONTEXT BENEFIT ADVISORS, LLC3 | 2425 CROWN POING EXECUTIVE DRIVE CHARLOTTE, NC 28227 | USABLE LIFE | $15K | — | $15K | 16.76% |
| MOSAIC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $6K | — | $6K | 7.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| INTEGRA EMPLOYER HEALTH, LLC EIN 56-1392505 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | PO BOX 1178 MATTHEWS, NC 28106 | $33K |
| MEDCOST EIN 56-1999192 PPO PROVIDER | Other fees Service code 99 | 165 KIMEL PARK DRIVE WINSTON SALEM, NC 27103 | $7K |
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 | 118 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 118 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF NORTH CAROLINA | 209 | $100K |
| Life insurance | USABLE LIFE | 113 | $88K |
| Short-term disability | USABLE LIFE | 113 | $88K |
| Long-term disability | USABLE LIFE | 113 | $88K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 209 | — |
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.